Which one radio frequency or Crio Ablation

Could anyone advise which is best radio frequency ablation or crio ablation not sure that's the correct spelling lol ,I've been referred to glenfield hospital which does the radio frequency ablation but that's an hour away for me , or my local hospital does this Crio Ablation 30 mins away , my friends mum has just had hers done here and all went well , thanks again Paul

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  • I presume that you mean CRYO not trio. ? Radio frequency ablation uses a catheter with a tip which is heated with radio frequency energy to create burns . These burns cause scar tissue which when it sets in about three months stop the rogue electrical impulses which cause the AF. A line of dots is made since the tip is very small.

    With cryo ablation a balloon is threaded into the catheter and liquid nitrous oxide fed into it. As this expands it gets very cold and creates a freeze burn.

    Now the tricky bit. Which is best. Best for what I would say. Cryo balloon ablation has the advantage that being round, a more complete burn can be made in the entrances to the four pulmonary veins which is where many of the rogue impulses start. IF that is the only place where they come from then cryo should sort your AF in one hit. The downside is that the balloon isn't any good at making lines of burn in other places within the atria so it is quite possible that a person can have a cry balloon ablation which doesn't stop the AF and then need a second procedure using RF techniques to clean up any other areas.

    There is no best method although many EPs are using cryo these days as it is quicker and can mean relief for many people with simple AF.

    Sorry for the lecture.

    Bob

  • Thank you very much bob , I like the lecture I need educating in this stuff ,it just throws another spanner in the works has to which one to go for :( I just want to get out of the horrible nightmare this has created thanks again Paul

  • It also depends upon the physiology of the atria. I have co-joined pulmonary veins so a cryoablation wouldn't work for me. Sometimes the EP cannot tell until they get a visual through the catheter as an echocardiogram didn't pick this up.

  • I agree with that one, Bob. Keep the lectures coming....,,.. Please.

    Nige

  • Cryro anytime. The success rates are much higher and the incidence of strokes during/just after the procedure almost zero.

    But as someone else said, it can't always be used so you need to ascertain this first.

  • Hi Paul,

    Havent got a clue on that one and look forward to learning the answer as I too am due an ablation.

    What I can say is that Glenfield is the place. I had my first cardioversion there last November and they have a fabulous reputation.

    Good luck,

    Nigel

  • I've just had a cryoablation(PVI) at the Oxford Heart Centre and so far it seems to have done the trick. Obviously I won't know for sure until the three month period is up but I'm in a better place at the moment than I was! The cardiologist said that my pulmonary veins were very electrically active. If I need a radio frequency tidy up, I'll be down there ASAP! Anything is worth trying in order to relieve the misery of AF!

  • Hi Paul,

    Have you now had your ablation and which hospital did you use. I am due to see my EP in the next month or so, to see if I need an ablation.

    Kind Regards

    Barry

  • Hi Barry , I've not had a date back just yet ,I went down to glenfield to see doctor Stafford about four weeks ago now ,he put me on the warfarin to get it in range for the procedure , he told me there was a three/four month wait at present , I asked to be put to slep for the procedure and he said that would add another month but think I will wait lol, I was back in a&e last weekend with a nights stay in hospital so it couldn't come to soon for me ,he did scare me with all the risks involved that I had to sign for but all he said was I don't have to have it done but the other option is live like I am not knowing when it's going to happen again , no thanks , the meds don't hold it off either so don't really thing I've got any options ,cheers Paul

  • Hi Paul,

    Thanks for your reply, seems like a lot of people have this condition, hence the long waiting list. I have Atrial Flutter (comes and goes), currently in a flutter, just checked my BP. On beta-blockers at the moment, will be put on warfarin in due course I would think. Diagnosed last Nov at a chance ECG. Have you started the warfarin yet? and any side effects. I take it that you live in Leicestershire, hence you are seeing Dr Stafford.

    Best Wishes

    Barry

  • Hi Barry , I also get the flutter mines peroxomol were it comes and goes , sometimes upto 20 hrs , I'm on bisoprolol and flecainide too but I still get af , the drugs slow me down I'm cold and sluggish all the time , yes started with the warfarin a couple of weeks ago touch wood no side effects has yet and I'm in target range 2.6 inr levels , I only started with this af last September but not sure if I've had it longer but not known about it , it's stopped me doing the things I love my running mr Stafford wasn't to keen for me to carry it on , but some say its best to carry on running I'm at a loss with what to do or who's advice to follow but think its best not to at the moment cheers Paul

  • Hi Paul,

    I have been a runner all my life, had to give it up in my fifties due to my knees, now I just swim, walk and bike. So Paul you have AF as well as Atrial Flutter. I not sure if I have AF as well. I will confirm with Dr Stafford when I see him.

    I had a 48 hour tape over the weekend. I did my BP this morning and I have been in flutter mode for over 24 hours now, so it seems that my condition is getting worse.

    Being a runner yourself you must have a slow heartbeat, so the question is what strength of bisoprolol have you been put on. I had my dosage reduced and I feel better for it.

    Best Wishes

    Barry

  • Hi Barry , yes my heart goes into a flutter when in af , I just checked my pulse one Sunday morning before a run and it was all over the place ,went for my run and only got 1 mile into my normal 7 miler there was no energy to carry on , I walked a bit then tried again same thing , when home I checked pulse because of my fluttering and it was still going ten to the dozen and all over , went upto a&e they told me it was af which I'd never heard of , went on a drip with flecainide and it sorted me out . Just keeps coming back tho , the cardiologist at the hospital put me on 5 mg of bisoprolol and 50 mg flecainide , it made me really poorly and my heart rate went rite down to 42 bpm , usually about 55/60 ish I never used to keep track of it till this af came along ,I decided to half the dose to 2.5 mg of the bisoprolol and was loads better cheers Paul

  • Hi Paul,

    Sorry to hear about the running situation, but it makes sense to lay of it for a while. I know how you feel, when I missed a day's training when I was younger, I thought the wheels would come off. I wish I could still run now, miss it badly.

    As to the best treatment for you in respect of ablation, I don't know, new to this as well, but BobD seems to have a great handle on this with his high quality advice.

    Keep in touch, and tell me how you are getting on.

    Best Wishes

    Barry

  • Hi Paul,

    What's the latest on you. I have now been put down for an ablation due to a problem with my 48 tape.

    Best Wishes

    Barry

  • Hi Barry , did they find you had af ? I'm down for an ablation currently I'm on warfarin and will have been within range for four weeks next week so have to let glenfield know so they can give me a date for the procedure I'm

    Currently back jogging at the mo steady when the meds let's have the energy anyway , hope your well Paul

  • Hi Paul,

    Just have Atrial Flutter, need to check that this is 100% true in due course. So are you telling me that you have to notify Glenfield that your INR is ok before they give you an date? When I was there I was offered 2 drugs, I picked one of the new ones, no blood checking.

    Best Wishes

  • Hi Barry , yes that's what I was told to do notify them when I had been in range for four weeks , I was just told to get coagulated preferably with warfarin so my doctor just put me on that , I'm not sure if you need to inform them with the other anticoagulants or not , suppose it all depends who you see to what they prefer , I will be ringing them next week anyway to let them know and get the ball rolling I'm still nervous about the whole thing ,I have opted to be put to sleep while its done anyway which he said would be a little longer on the waiting list , I was back in hospital with af over Easter again , cheers paul

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