Cryoablation vs Radiofrequency Ablation for Afib

[beaversbro]

I am searching for feedback from those who have experienced either the cryoablation or radiofrequency ablation for Afib.  I am a 46 year old male who has paroxysmal Afib and is seeking treatment because of symptoms.  

I am interested in knowing the research you conducted, the complication rates of each and your experience.

Thank you in advance for taking the time to provide a response.

[rcv]

You're welcome. Another point I would make is that my primary care physician and cardiologist were interested in controlling the afib with the rate control medication metoprolol. The side effects of that medication were nearly disabling but they would have kept me on it. Dr. Niebauer, an EP, on the other hand was interested in eliminating the afib and prescribed the rhythm control medication rythmol in addition to a lesser dosage of metoprolol in anticipation of the ablation. After about a week I felt much better. So these doctors took much different approaches to the condition. I really understand your feeling limited. The condition just took me over. Anxiety predominated. I was unstable and wondered out loud sometimes what should I do. My girlfriend and I are very active and adventurous international travelers. I saw all of that coming to an end. I grieved the passing of the old me. I'm a new person though now after the ablation and I am embracing it. I've taken on a more heart heathy diet. I'm losing some weight and am gradually increasing my level of activity. I am positive that my quality of life will return. You are on the same path. Your March consult is right around the corner.  You'll know more then and end up just fine. Then you'll be back on websites like this sharing your story as I am.

[DeltaDawn23]

Thanks for your very informative post.  I'm looking forward to getting an opinion from the Cleveland Clinic.  My doctors here cannot agree on what should be done.  Afib is very limiting -- I fear taking a trip, getting too far away from home -- never knowing when it's going to strike.  A cure would be a wonderful thing -- life changing.  Thanks again.

[rcv]

Dr. Niebauer is my EP there. He is excellent. Completely honest (tells you what you may and may not want to hear consistently with everything you read online). I am from West Virginia. So it's a drive of several hours for me to the Clinic. I stayed at the Intercontinental for a day or two after the procedure to get some sense about the healing of the catheter insertion points. Incidentally, the friend I mentioned who also went through the procedure with Dr. Niebauer was afib free last I spoke to him. Also, I was speaking with a younger woman at my workplace who I have seen in the hallways from time to time over several years and she told me she has afib and has had it for years. She indicated that she had an ablation several years ago and it didn't work so well. So she is doing well now on rhythm control medications and thinking about another ablation. Hers is hereditary, she said. It's amazing to me how many people I know who have this condition. I am very grateful for their willingness to share their experiences with me. For them as for me it's been a pretty big bump in the road but definitely one you can put behind you with the medical technology and expertise we have now. I am sure you will make the decision which is right for you with the guidance of your doctor at the Clinic and as you research online and speak with others you know and through websites like this. I wish you well.

[DeltaDawn23]

Not sure where you are, but the Cleveland Clinic is one of the best in the Midwest.  While you are researching, you might want to look into the FIRM ablations.  They are relatively new (last 4 years or so) but have a higher success rate and are being offered at more and more hospitals, including the Cleveland Clinic and several others across the country.  I am still looking into it as my afib episodes are getting closer together.  rcv is right, the medications do slow one down.  Good luck to you, keep us posted on your progress.

[DeltaDawn23]

Do you mind my asking who performed your ablation?  I have afib and am being evaluated at the Cleveland Clinic in early March.  Your post is gives me hope.

[rcv]

I had pvi cryoablation at Cleveland Clinic in January. I'm a 65 year old male. I learned that I had afib last October. I was prescribed metoprolol at first but experienced significant side effects and breakthroughs. I then learned that a friend of mine also had afib and had an ablation at the Clinic later last year. I made an appointment with the same doctor he had and met with him in early December. He prescribed rythmol and the date in January was set for my ablation. I did much better on the rythmol and wondered whether I needed to go ahead with the procedure. I read everything I could on line, watched YouTube testimonials and doctors' discussions and found that there was a low risk of serious complications but a relatively high possibility (70 to 80 percent) that I might be afib free and off medications. I have been very open about having afib and was surprised to learn that several people I know have also had it. Some have had ablations and some have taken the medication route. Interestingly, those who opted for ablation have more active lifestyles. I learned a lot from talking to them. The best advice if you want to have the ablation. Have it done at a place like the Cleveland Clinic by an EP who does several a week, not two or three a month. I had and have complete confidence in my doctor. That said and after all of my research, it was still scary. It's your heart after all. But having had the procedure, it was not so bad. I feel better and stronger every day. I am still taking the rythmol and xerelto. My pulse was high after the procedure but has been gradually decreasing toward normal for me. I have an app on my phone to measure it. After about a week, I started going out for a walk. After two weeks, I was walking three miles a day. I hope to resume jogging in a week or two. It's way too soon to know whether the procedure worked. I'll find out in April. I suppose the message is that if you enjoy vigorous physical activity as I do and don't like taking medications,ablation might be worth it to you. Hope this is helpful.

[twinbee]

I too had an ablation done for a-fib & a-flutter. My EP did both RF & cryo also. It took me 2 years to have my ablation. The "research" I did was for the best doctor I could go to. I saw several of the top EP, then decided on who I wanted to do the procedure. I can't remember the complication rate I was quoted at the time, but I do know it was very, very low. I was told the success rate would be around 75% for first procedure. I was also told that there could be a chance that I would need up to 3 procedures to "cure" my a-fib. I am happy to say that I have only needed the one. My ablation was done January 2008, and I have been in NSR ever since. If by chance my a-fib returns, I would not hesitate to go and have another procedure done. Good Luck!

[Robb S]

I had an ablation for Afib last October.  I just saw my EP again today.  We had a short conversation about the effectiveness of the cryo procedure used to isolate my pulmonary veins.  He said that the newer cryo balloon can be as cold at -30 degrees, which is more effective than RF for the pulmonary vein, not only because of the depth of the freeze, but also for the uniformity of the lesion that is left on the vein walls.  Doing the same with RF is less likely to get every hot nerve cell in the circular lesionl.  The rest of my procedure was done with RF- places where he needed a straight line or at a single point.  After 3 months the jury is still out on the success of my procedure.  I believe that using both cryo (for PVI) and RF in the same procedure is quite common today.  I have read about using cryo for the whole thing and how it is safer (less chance of an esophageal fistula) but I'm not sure if using cryo other than for PVI is as effective as RF.