AF Association

Medscape Medical News from the European Heart Rhythm Association (EHRA) EUROPACE–CARDIOSTIM on Medscape > Trials an

This is probably a worthwhile read.

Some excerpts:

"When it comes time to perform AF ablation, many ask the question: Should we freeze or burn? Which technique of pulmonary-vein isolation (PVI) is best?"

"The two most common techniques for PVI are point-to-point RF ablation and cryoballoon ablation. Heat or cold? Fire or ice? Dots or circular lines? At electrophysiology meetings, this is a hot—not cold—topic."

"Here, I think it best to consider this debate from a patient's viewpoint. In other words, if you were the patient, which technique would you choose?"

"One factor you would consider is the experience of the doctor and center. Both techniques of AF ablation require skill, but most electrophysiologists would agree that point-to-point RF ablation demands more time and procedures to master. Compared with the one-shot PV isolation with a cryoballoon, RF ablation involves intricate movements and delivery of many singular lesions to isolate the vein. Where an operator is on this experience curve may be an important factor in comparing the efficacy and safety of the procedure."

4 Replies

Oops I have posted too many articles I guess. I messed up the title which should have been:

Fire or Ice for AF Ablation? Operator Experience Counts

Sorry I should have checked more closely.


One must also understand that whilst cryo balloon ablation may well be effective for patients with simple PV signals, it will not control those extra areas away from the PVs which may require ablating and need subsequent re-visiting with RF.


I had the cyroablation 8 weeks ago. I have had Afib for years and in 2011 my heart went crazy and finally stopped and I ended up with a pacemaker and spending 3 weeks in ICU trying to get medications that would stop the madness. So far the ablation is holding. I live near Washington DC and had a very good EP Cardiologist who only does ablations. (They say you should always find a Dr. who had performed over 1000 procedures). I requested my chart from the hospital. When I received it and read the surgical notes they did the cyroablation but also used the RF. They eliminatied 3 paths that were causing problems. It took 4 hours and unfortunately I woke up during surgery. The end was a mess but I am lucky for now with no afib . However I still take 120 Sotalol 2x a day and I take warfarin. I wish everyone on this site the best. I so enjoy reading your post. I have learned a lot. There appears to be a lot of differences in how they treat afib in our different locations. I intend to ask more questions on Thurs when I see my doctor again.



I live in the Tidewater area of Va. and had a cryoablation with some RF touchups about a month ago in Richmond. Do you mind telling your Dr.'s name? We may be moving closer to D.C. to be near our grown children.

By the way you are very lucky. I'm still having episodes of Afib just in the evening.

Heather R


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