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AF Association
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Ablation : Cryo versus Radiofrequency

Hi fellow A Fibbers, am trying to choose between a Cryo and Radio frequency Ablation. Would welcome opinions as to which is the ablation of choice and why?

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I had cryo cardio said it was better as they freeze the circle in one go

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i had cryo,and understad it only isolates the p, veins ,it is apparently easier to perform,and as i am lage 193cm does not require you to be quite as still, to do with the amount of sedation, pain relief required

i found it very painfull even so

my EP said it,a one trick Pony,

it is 3 month ago and i am not in rythm,

so i expect i need touch up with R/F,but am awaiting a appointment.

Which he said may be the case,before the procedure.

for me R/F at the start, may have been better but one can only be guided by the EP

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cryo can be more accurate but cannot reach the whole heart. Go with whichever your EP says is best for you

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I'm very happy to be corrected on any of this but as I understand it, cryo can only be used for pulmonary vein isolation (PVI) ablations - the most common - and if you've been offered cryo then your AF is probably in this category. However, if any 'rogue electrics' are encountered elsewhere within the atrium - certainly not uncommon - these can only be zapped with RF ablation. If this occurs during the procedure and the EP doesn't have the right 'tools' with him, so to speak, you are probably destined for a second ablation (RF) further down the line. If your EP is confident that your arrhythmia will be entirely resolved with a PVI then cryo is probably the better of the two options.

You'd have a similar dilemma at the roulette table....red or black?

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I will not correct you Robert as you have just explained what I have so many times in the past. This question is not about which is best any more than you can compare apples to pears. Cryo is often chosen first as it take far less time to do so more patients can be done in a day. Two in the time RF takes for one usually. It is most appropriate if the procedure is done early in a patient's AF journey before too many extra pathways have formed.

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I was unable to have cryo as I have 3,not 4 pulmonary veins, one of which is 'huge' according to my EP. This is not uncommon but it does mean some people are not able to have cryo.

It would be for your EP to decide which is most suitable for you. With Cryo you will be done and dusted very quickly whereas with RF you will be on the table for a lot longer - mine were both around 6-7 hours.

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My cryo was done under GA so felt nothing still took 5/1/2 hrs I have to have rf touch up as still having AF but not as bad

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Had Cryo for my AF, it didn't work. Had to have RF three months later, that stopped my AF however then developed SVT within a week of the 2nd Ablation, so had RF again three months later. Now another three months on and seem to be symptom free. Personally I would go for RF as opposed to Cryo, seems to work better.

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Google them to see which has the highest rate of success .... Check the success of the medical facility you are going to and the person who will be preforming the procedure . Give yourself the best. I waited 6 mo to get the Doctor I wanted. Success, going on 11 years. I wish the same for you. Pam

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Great to hear the success sweetiepye. So which did you choose? Cryo or RF?

I live in California, I’ll have to research and see who has better success rates.

Thanks for your share

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I had RF ablation just about 3 weeks ago. I live in the States and went to a very reputable hospital with an equally reputable EP. He only does RF ablation...didn't offer me cryo. Although cryo, from what I've read, sweeps a broader area around the pulmonary veins, it cannot do other areas of the heart like RF can with its tapered head. So that's one advantage of RF, is that it gives the doctor more flexibility. Cryo is good in that it is less likely to leave gaps around the pv, so it is faster. Think of it as putting a stamp of ink on a circle, rather than using the tip of a marker to fill in the circle. So I would certainly go with your EPs suggestion of what he/she feels is your best option (but ultimately it's up to you I suppose), but I would leave it to the experts. I was in hospital overnight, and had a really good recovery. Rather easy so far I'd say, although many people on this site have a much tougher recovery and it varies from person to person. I'm still just 3 weeks past it but am back to work for the second week and doing very well...feeling stronger every day and heart is pretty calm. I am aware tho that it can take at the very minimum 3 months to heal while the heart forms scars. So whatever you and your doctor decide, best of luck to you! Keep us updated.

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Lovely positive post there Jomama.

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