Cryoballoon Pulmonary Vein Isolation

Hello to everyone on this site again, I am also in touch with our American counterparts on the subject of AF/SVT which I have, I am now going to undertake an ablation after 4 years of medications and lifestyle changes, which I am glad I have undertaken first because it has afforded me knowledge of other conditions contributing to AF/SVT. I am currently on Metoprolol 25mgs x 2 after coming off the drugs of Sotalol and Amiodarone, which has amazed my EP after seeing him last week. It is still paroxysmal but I am not prepared to go back onto Sotalol or Amiodarone. I showed him the list of medications which I got from a few of you but he was suggesting they are not suitable. There are a few risks I must say which frighten me a little but I was hoping someone would have experience with Cryoballoon Pulmonary Vein Isolation procedure on this site. I am in touch with one other person who has had this done and was wondering if any more insights can be added. Thanks

30 Replies

  • Cryoablation is much quicker and easier than RF but is only really effective for paroxysmal AF as the balloons fit into the pulmonary veins and offer better isolation than RF. To this extent I think that it is a better procedure for PAF as the rogue electrical signals are usually emanating from inside the pulmonary veins. There is the risk that there may be abnormal veins or some other reason that the balloons cannot be used in which case a second RF ablation is needed. However, my view is that for the majority of people with PAF cryoablation is a good place to start with a first time success rate between 60 and 80 percent. As ever it is important to go to a centre that carries out a lot of cryo and has a good success rate

    It certainly worked for me, 16 months since cryoablation, still in sinus rhythm and off all drugs.


  • Hi I had a cryoablation last October all very straight forward and touch wood have not been in AF since so so far so good. I do get a lot of eptopic beats and occasionally feel like I am going into AF like I use to but still stay in normal sinus rhythm.

    Wish you lots of luck


  • Thanks Robert 185 I will need to work out how and when to get home afterwards as I believe you need to take it easy for a while. I will be travelling by plane to get there 1hr and taxi to the hospital. I will most likely have to stay in the first night and maybe can stay at a hotel the night after before flying home. I am so glad I am getting replies thankyou.

  • I experience the same thing . Had my ablation Feb 2016.

  • thanks so much Peter, I have SVT/AF I have just been told that the operation will take place on 30th September, in a Private Hospital, I saw him the other week, and gave him my summary of 4 years, he operates through an Arrhythmia Centre where I saw him for a chat and says they do 140 per week. He stressed the risks, and that's why I am concerned. He also told me he would be looking around to see if there are any other problems. So I am not sure of the length of surgery. I will also be getting a scan of the pulmonary veins first? It sounds promising and I do have faith that I have chosen the right person, but still not clear about the SVT and AF together. I am scared alright, the only medical procedure under GA I have had was when I was 17 years old. It makes me feel better already hearing from you. Thankyou

  • The downside frightens all of us, but do remember the risks need to be divided into two: those that will be treatable with no long term adverse effects and those that may be life changing.

    All procedures can be risky - but if you have already explored the alternatives, the time comes when the ablation nettle needs to be grasped. Yes, there's a slim chance the outcome might be poor but it's more likely to be better, much improved, good or excellent.

    It's more stepping into mist than a leap in the dark and lots of us are glad we went for it.

  • Hi Rellim I remember you from way back, around the same time I believe as myself. Thanks I think I am stepping into the mist already I can't believe I am going under the knife at my choice. I know its the right thing to do though, I have definitely reaped some benefits of the numerous and many hours of research and change of lifestyle, that I have undertaken, with help from you all when I needed it.

  • Yes, AF is a great incentive to lead a healthy lifestyle!

    I haven't had cryoablation but it's just a bit of freezing and things wandering through your veins - and a step your EP thinks will lead to better things! But however helpful doctors can be, it's fellow AFers who really understand where you find yourself and the forum is such a great source of knowledge and support.

    By the way, the scan of your pulmonary veins will show up anything odd and also give an idea of the anatomy as at least 25% of hearts aren't plumbed with the usual four veins. Some have five, some have three.

    All the best!

  • I agree Rellim I felt really good getting these replies as you start to imagine all sorts of things when your on your own. I wondered why they were checking the veins. Thanks again.

  • I had 2 RF ablations and am one of those people with 2 normal size veins and 1 co-joined 'huge' vein, according to my EP who did the procedure so I wouldn't be suitable for cryo procedure.

    by the way - no knives are involved apart from the initial incision into the vein to insert the catheters. It is all much easier than you think, however, my concern for you would be aftercare - especially if you are not travelling home and I can understand why if you live so far away. You will feel pretty exhausted and need some time to recuperate.

    Is there absolutely no-one who can accompany you and just be there for support?

    There used to be an agency who would accompany people for these types of occasions, but of course that would be added cost. Perhaps you could ask the hospital what they suggest.

    Best wishes CD

  • Thanks CDreamer I will be organizing someone to be here when I come home, ideally I would like to have someone with me throughout the whole thing, as Sydney is a huge cosmopolitan. have rung an organization who I think can help and might know a bit more than myself I expect a phone call soon. I have already rung a couple of people where I live, but they are either working or are too sick themselves to help out. My cover is pretty good for hospital and/or after care if needed, I just need to get to the right people. As Rellim says need to keep calm about it all, I might ask the doc today about anxiety tabs or something, but I am usually pretty good at deep breathing and relaxation so will see. Thanks to you and everyone you are so kind to give me words of comfort. I am glad there are no knives, as I had a large cut when I was young for an appendectomy which got infected later on. So I will try to keep my mind clear on that point.

    Thanks to everyone for just being there.

  • If you have made the decision, don't think about it too much and hold your nerve on the day! The waiting is worse than actually arriving in the lab for the procedure when you can be dazzled and amazed and impressed by all the technology. I remember a nice lady telling me her job was to make sure I was OK all the way through and she said I might not notice her (I didn't) but she would be watching me like a hawk. Very reassuring.

  • You are definitelyright! The waiting is the worst part!

  • Hi. I have PAF and had cryoablation under general anaesthetic two weeks ago. I was very nervous going in but I had faith in my EP who does them all the time. I was glad that I had a GA as I didn't know anything about the procedure and just woke up afterwards.

    I'm doing really well and started back to work yesterday. I've not had any AF episodes since my ablation just some missed and extra beats now and again.

    I would recommend ablation to anyone as it gives us the best chance for a cure. Every time I ended up at A&E with an AF episode they always said why don't you have the ablation. On one occasion in A&E one of the young doctors also had PAF and we had a very useful chat. He us booked in for his ablation in October.

    Hope this is useful


  • It helps a lot JoolzC thanks, I am probably wary as I am 76yrs old, whereas your body heals when you are younger. I am fairly fit for my age and nothing else of major concern. Still its a big thing for me to finally get it done. I hope mine is as straightforward, and I am doing my meditation every day to help my nerves a bit.

    Thanks a lot for replying

  • Hi Ultramarine, I had my cryoablation done in Bristol in 2008 and apart from feeling very tired for about a month and a few spells of PAF whilst my heart settled I was really pleased to get on with life. Before the cryo I had to plan when I could do things as my episodes were fortnightly which was really quite limiting. I now carry Flecainide as a PIP just in case. Not used very often, I can now garden all day!!

    I only had mild anaesthetic not a GA and after a rest to check I was ok I went home with my husband looking after me.

    All the best with your procedure,


  • Thanks Jackie, mine has been once a week now over about 1 month, it used to be only once in a while, especially when I overdid things, I also had it fortnightly before then, and couldn't commit to anything which effects your quality of life I agree. He might need to check for any other leaks or something like that he told me. I feel good now I have decided to get it done, as the thought of it was really daunting. I am a widow, so will need to organize some help for me which I will do before I go (a lot of planning). I am lucky I am fairly fit still, and do exercises and walk every day. Plus am involved in the community in a big way. It is so helpful when you are on your own to have this forum thanks to everyone.

  • I am so glad that you have finally decided to go ahead and I am sure that you will be happy once it is all over. Please don't think of it as surgery though as it really is not. It is a procedure since you don't go home with a large zip up your front. You are not going under the knife at all more like a wiggly wire. lol

    That said I don't envy you the logistics. In UK we are not allowed home alone and preferably not on public transport and should not lift anything for some time afterwards due to the risk of bleeding from the small access point in your groin. You may be able to arrange something with the hospital so why not discuss this with them first. I think a hotel would be an excellent idea if the hospital can't help but do be flexible. I had a car arranged to take me the four hours home only to have to stay in an extra day due to a bad reaction and then have all the stress of re-arranging transport. I found this more stressful than the procedure to be honest.

  • Thanks for your support Bob, Yes a lot of planning ahead, I have a very good medical cover but have not had to use it before. I will think of it as a procedure as you say. I have around 5half weeks to organize things, and will be starting tomorrow with a visit to my local GP and another organization here, which has more experience with cover for transport etc, and any help at home after the "procedure". The organizing is as you say stressful in itself, even when I flew last week just for the chat. Since then I have telephone numbers to ring, if things don't go as planned as you say. Thanks for reminding me, and for your concern too I appreciate it.

  • I had it done Feb 2016 . Best decision ever made. Just know that it takes a few months for your heart to heal.

  • Thanks Rgm I should be right for Christmas then.

  • I just had a cryoballoon ablation on July 13th. After eight days I had an 8 hour AF episode. It may have been a combination of working too soon in the hot sun, then taking antibiotics before going to the dentist. I was only in the sun for an hour and a half, but it was 100 degrees. I'm still taking my medication. Diltiazem once a day, and propafenone three times. For 28 days now have been in NSR. I've been lifting weights ( nothing real heavy), and I just swam the length of my pool up and back under water for the first time since the procedure. I hope to make it through the three month blanking period, and then be weaned off the meds. So I would recommend having it done. I understand it is supposed to be safer than the RF ablation. Best of luck to you. As I've said before; I HATE AFIB!! Deadwoodmike 😎

  • I don't think that it is safer and have seen nothing to suggest that. However it is supposed to be more effective ;medically and cost) first time and also quicker because it is a balloon opening up to freeze the point where the vein enters the heart in one go rather than a series of pinpoint RF burns around the entrance that are then dependant on becoming a complete rung during the healing process.

  • Thanks PeterWh I am not sure about other procedures but I have some information which the EP gave me and there are 5 risks which could be serious, and I would guess there are some for Radio Frequency too. I think it all depends of the experience of the practitioner and how quickly your own body heals. I went to my docs today and she is putting a plan in place for me, and I am sure she will guide me through the maze, the only problem I can see at the moment is the distance of travelling, which Bob alluded to before, so I am organizing this at the moment, and will try to find out more before I go. Thanks for the information What did you have done?

  • I had RF ablation because that is what he said was best but that was over 21 months ago. Had ablation March 14. I didn't know forum existed Jan 14 but I had read up AFA information at that time. Also I was in persistent AF which may have made a difference.

    I must admit I knew very much more about AF now then I did then. Also cryoablation has developed more in those 2 years. Who knows whether it would be the same decision today.

  • Yes it might have been the best for you with persistent AF and maybe your EP was more experienced in this too. I didn't get a choice so I am guessing hes an expert with this cryoablation. I trust him anyway and I will be having a scan of the pulmonary veins the day before which I take to him on the day of the procedure, all high tech stuff. The funny thing is I am giving my blow up bed away on Sunday to someone, its where you jump up and down with your foot to get the air in. Now there are better ones on the market which blows up automatically no comparison really but I thought I would throw this thought in I have a weird sense of humour.

  • My regular cardiologist suggested I have the ablation done. He's the one who told me he believes cryoballoon is safer than RF. Maybe he just didn't want me to worry anymore than I already was! Either way, I believe you'll come through it just fine. 😎

  • Thanks Deadwoodmike

  • Thanks Deadwoodmike, Well! I can't imagine me doing any of those things even without the surgery except of course the dentist if it was an emergency.

    You seem pretty gung ho and quite young I would guess. Thanks for your recommendation, I appreciate your reply... I am trying to work out how not to do too much also, and I also dislike Afib episodes, at times you seem to have no control over your own body, which is not a good feeling.

  • Well, I feel pretty young, in my head at least!😂 I'll be 59 in a couple of weeks. I'm keeping my fingers crossed in hopes that I stay in NSR.

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