Cardiac Catheter Cryoablation

Much like a cardiac catheter RF ablation, cryo-ablation is a curative procedure for patients suffering from uncontrolled or poorly controlled atrial fibrillation / Afib or other treatable arrhythmias. The single, most significant difference between the two procedures is that cryoablation uses cold versus heat to destroy improperly functioning heart tissue. The use of cryoablation versus a heat-based ablation depends on your electrophysiologist’s preference, however and we encourage you to discuss both options with your EP.

How the Procedure Works

A cardiac catheter cryoablation is performed in an advanced electrophysiology or EP lab at the hospital. During the entire procedure, patients will be sedated or placed under general anesthesia to ensure comfort. Patients should feel no discomfort, during the procedure. A small incision is made in the groin and a long, thin catheter is inserted into the femoral vein and threaded to the heart. This flexible catheter technology has virtually eliminated the need for more invasive treatment of cardiac arrhythmias. Once your EP has reached the heart, a 3-dimensional map of the structures of the heart, as well as its electrical signals, is created. This allows your EP to understand where the arrhythmia is coming from in real-time.

As we have discussed elsewhere on the website, arrhythmias can be paroxysmal or occasional. This means the patient may not be in Afib during the procedure itself. We can, however, induce an arrhythmia either mechanically or chemically. Once we identify the areas to treat, we apply gradual cold to the area being treated. This cooling gives us a preview of the results. If the preliminary cooling is successful, the full cold blast is deployed, and the tissue is ablated. The tissue is destroyed and slowly absorbed into the heart over the next few weeks.

Benefits of a Cardiac Catheter Cryoablation

Much like its heat-based counterpart, a cryoablation is very effective in properly selected patients and we expect upwards of a 90% success rate. However, most arrhythmia patients will see improvement after a cryoablation. Resolution of Afib and other arrhythmias can significantly reduce the risk of stroke, heart attack or long-term heart failure. Some patients will remain on antiarrhythmic and anticoagulant medication; however, the vast majority will be able to reduce their dosage and subsequently reduce the side effects of these medications.

The Risks of Cardiac Cryoablation

A cryoablation has similar risks to a heat-based ablation which includes pain, bleeding, or infection at the incision site at the groin. The procedure can also lead to damage to the blood vessels or the heart as the catheter moves through them. Fortunately, these serious complications are very rare. Most patients will feel some discomfort in their chest after the procedure. They may also experience arrhythmias for up to a week or two after the ablation as the tissue is being absorbed into the heart. Patients may also feel some discomfort at the groin incision, which can be managed with over-the-counter painkillers.

When choosing a cryoablation, the most important first step is to speak to an experienced and qualified electrophysiologist to understand your options. Cryoablation alone can be very effective in well-selected patients. Ablations are the latest and definitive treatment for certain arrhythmias including Afib. Details will be discussed as part of the patient’s initial consultation.