Cyro or RF Ablation

[easygoer13]

Just wondering if anyone here knows much about the differences. I have found in the US most of the Doctors who seem to be most active 5 a week or more are doing RF and those who do them less frequently will do either or Cyro anyone have any thoughts, opinions to each

[djbgatekeeper]

My EP told me the Cryo is used as a broad brush approach first line of defence and RF ablation is used as a second more pin point process for any missed areas if the problem persists ... I had the cryo Sept 18 and not had the need for further treatment thankfully.

[CDreamer]

Depends - cryo is broad stroke but if your arrythmia doesn’t originate in the the Pulmonary Vein or if you have atypical physiology as I do - 3 pulmonary veins rather than 4 and an unusually small atria - then RF is the only way.

Cryo is a much quicker procedure - 1 hour or thereabouts - whereas RF takes much longer - both mine were 7+ hours. Many have cryo and then need a ‘touch up’ if there are missed areas as djbgatekeeper says.

[jennydog]

I have the same plumbing as CDreamer and I understand that 25% of the population do as well.

Essentially 2 conjoined veins enter the heart as a large hole and the cryo balloon is to small for it.

[Jjda]

I had cryo a year ago. It was a fairly long procedure because I have "oddly shaped arteries". I have not had any episodes of Afib since. I am not sure why the EP chose cryo over RF, but I also think that cryo is a newer technology.

[Dangerousdriver]

I had both RF and Cryo at the same time and I was told it was to do a belt and braces job and hopefully negate the need for another ablation down the line. So far it’s doing ok, but still not perfect.

[Breezera]

I had a PVI cryoablation in August 2018 (procedure time was roughly 90 minutes) and I've been completely afib-free since then. Months prior to the procedure my EP recommended cryo for me as opposed to RFA, citing my long-standing gut issues (i.e. hiatal hernia, GERD [GORD], moderate nutcracker esophagus) as the principle rationale for going wth cryo. Apparently there is slightly more risk for damage to/complications of the esophagus with an RF ablation as compared to a cryoablation. Conversely, in going with cryo there's a slightly greater risk for phrenic nerve damage. After weighing all the "pros & cons" of both methods I/we decided that cryo was the best choice for me.

Best wishes,

Richard

[easygoer13 in reply to Breezera]

Thank you Richard,

Good to hear you are doing well. What I have found is the Doctors who seem to be most active in ablations seem to be doing more RF's. As you mentioned there are pros and cons to each and different risks. For me my question is am I bad enough to do the ablation or first try life style changes. I am leery of controlling it long term with meds if an ablation is more of a long term management.

I am feeling great and physically even when I was in afib I felt pretty good but psychologically it was challenging, it really weighs on me like I am sure it does most others.

Harry

[KMRobbo]

I had cryo for afib and have not had any issues since, nor no afib (20 months). However I am sure it took longer than 90 minutes!

Unfortunately developed re entrant atrial flutter 9 days after the cryo (possibly promoted by the flecainide I was taking) and had an RF ablation on the right atria to stop this . Again no issues and no flutter since.

[easygoer13]

much continued good health to you