Ablation vs Cyroablation

[glenpointe]

I'm wondering the advantage/disadvantage between Ablation vs Cyroablation? Which procedure has higher successful rate? Thanks,

Glen

[rosyG]

Hi there,

They are both types of ablation Cyro uses freezing and RF ablation uses heat in order to cause scars which stop the electrical signals getting through and making the heart fibrillate.

Cyro has improved but is only used around the pulmonary veins so if more areas need ablating you may have to have RF ablation.

Your doctor will advise - they will study what ids happening and act accordingly

[BobD Volunteer]

They are both ablation but I presume that you are asking about Cryo against Radio Frequency. IE cold against heat.

Cryo is much quicker to do as they use a small balloon which is inserted into the entrances of the four pulmonary veins and ultra cold gas pumped in which makes a freeze burn in one go. RF uses dot burns which take much longer to do and may allow some gaps. If you look at AF Association website there is an excellent booklet explaining both procedures.

The problem with Cryo ablation is that whilst maybe more effective at isolating the four pulmonary veins it has limitations. If as with some people the PVs are not the normal size or shape or can even be conjoined where they go into the heart, then the balloon may not be able to isolate it/them. Also there may well be other areas of the heart firing off which they are unable to reach and In such cases RF ablation as a follow up at a later date may well be required.

Due to the easier work and faster procedure. many centres automatically will try cryo as a first intervention and hope that this is sufficient, This way many more people can be treated often with good results.One leading EP once told me he could do three or four Cryo ablations in the time he might have taken to do one RF. He also uses a robot and sits outside the lab away from the Xray exposure which makes his life so much easier.

Yes they use Pulsed X ray to see what they are doing so again cryo gives the patient less Xray exposure which must be a good thing.

Hope some of,that helps answer your question.

[Hidden]

Hi glenpointe. I'm assuming you mean and RF Ablation and a Cryoablation. I'm not medically trained so I'm only expressing my understanding of the main differences and many of the terms I have used will not be found in Lancet!!. Firstly, and RF ablation is where heart tissue is burned to form scars and a cryoablation is where tissue is scarred by freezing.

Cryo is a relatively new procedure, a balloon is expanded in the entrance of the four pulmonary veins and then a freezing agent is applied to scar the tissue. It is generally a quicker process because it scars more of the tissue with one zap, the downside is that the PV's are often not a regular shape so the balloon might not totally cover the entrance to the vein. It is therefore not unusual to have to have a follow up procedure, normally RF, to zap the tissue which was previously missed.

RF is a slower process because the EP identifies the areas to be zapped using sophisticated mapping equipment and then he uses a lance to burn the appropriate areas of which there are likely to be many.

Because it is very often the tissue around the pulmonary veins that cause AF, it is becoming more common to have a cryoablation first and these can be very successful. There is a lot of information about both types of ablation on the AF webpage and also British Heart Foundation webpage and you should check these out as I have only provided a brief account of the differences as I understand them and I wouldn't want to mislead you.......

[Hidden in reply to Hidden]

just seen BobD's post......forget mine and go with his!!

[BobD Volunteer in reply to Hidden]

Yours wasn't so bad Flapjack. lol

[JoolzC]

Hello. I had cryoablation but my EP advised on which type he believed would be most successful so I would take your EPs advice. Mine procedure was relatively quick and straightforward so far successful - I had it done summer 2016. Good luck!

[UScore]

I was told on the morning of my ablation that it would be a cryo-ablation. The consultant said that he always did this type for someone relatively young like me because "it was the quickest, least painful, and easiest recovery". When I asked why you wouldn't also want those things for an older patient he gave such a waffly reply that I didn't bother asking him any more questions.