Thermal Abaltion vs Cryoablation

[Peakoverload]

So after 9 months of waiting, next week I get to have a telephone appointment to discuss next steps in my treatment. My understanding is that this will be to discuss which type of ablation to go for. Apparently each is performed at a different hospital that my cardiologist works at and the waiting lists differ.

I've been doing some reading on the differences and I like that the cryoablation seems to allow for more accuracy in choosing where its to be applied. That said, some reports I've read suggest that thermal has a slightly better result when it comes to reoccurrence although as cryoablation is relatively new, there is less data available.

Just wondering that, given the choice, which you would choose? Also if there was a longer waiting list for your preferred one, would you choose to wait or have the other one sooner?

I think I'm leaning slightly more to cryoablation but not by much.

[CDreamer]

It also depends upon your physiology as I, along with a fair proportion of the population, have one co-joined vein, cryoablation which uses a small inflatable ballon would not cover the area so mine had to be a RF ablation. Having said that, cryoablation is quicker procedure but sometimes does require a RF follow up ablation.

Given the choice and IF I were a suitable candidate - I would choose cryoablation simply because it’s less time on the table.

[BobD Volunteer]

Cryo ablation is usualy faster BUT it does need you to have nice neat pulmonary veins. If they are odd shapes or even conjoined then the results may be poor to say the least. It is usually offered as a first line attack as many people enjoy good results from it. The RF type ablation is often used as a follow on to tidy up areas not touched by cryo. In some parts of the world EPs may use both methods at the same ablation but not to my knowledge here in UK, not least because RF is usually done under GA whilst cryo under sedation.

You can see then that there really is no best. Horses for courses as they say and one ever knows if one is a race horse or a cart horse till they get inside.

[mjames1]

First generation Cryo may have been inferior to RF, but second generation Cryo gets the same results per the Fire and Ice trial. I choose Cryo because it involved less table time, less anesthesia and was less operator dependent. You should also know, that at least in the US, ep's who do Cryo afib ablations (PVI's) also use RF during the same procedure if necessary although in most cases of a first time paroxysmal, a basic PVI is all that is needed and all that you want. Another good option is the newer Pulse Field Ablation (PFA) if available in your area.

Jim

[Teresa156]

It depends really on the protocol of your hospital. I’m having an ablation this week ( eek!) and was told the first is always a cryoblation, there is no choice that I need to make. I am in the UK.

[50568789]

One week to go for ablation after 8 month wait. Haven't seen EP since that appointment so assume nothing has changed, but he was pretty fixed that he wanted to do cryoablation, all round the best choice for me, who was I to argue? Proof will be in the pudding.

[Poncegirl]

Hi Peakoverload, I had a cyroablation in August 2021, my afib and SVT have totally stopped. Now off eliquis as of this past January. No heart meds at all. It gave me my life back Best to you !