ablation - heat versus freezing

My atrial fibrillation has not been controlled after a 6- month drug trial, and I have decided to undergo ablation. In seeking a second opinion, I was informed there is now an alternative to the traditional radio frequency ablation, which uses heat to destroy heart tissue. Apparantly it is now possible to freeze the tissue rather than burn it. Does anyone have information about how thee two procedures differ in terms of success rates and risks?

Meredith

[merileegal]

Before I had my ablation of SVT (AVNRT) I also wondered the same thing. From my research I found that rf is likely to be more successful because it is more likely to destroy the tissue permanently. Cryo is safer to use around the AV node where my ablation was but is less successful requiring a possible second ablation in the same spot to achieve the same results.

[merileegal]

Before I had my ablation of SVT (AVNRT) I also wondered the same thing. From my research I found that rf is likely to be more successful because it is more likely to destroy the tissue permanently. Cryo is safer to use around the AV node where my ablation was but is less successful requiring a possible second ablation in the same spot to achieve the same results.

[DrMeredith]

Thanks for telling me about your experience, merileegal. I am a novice and am slightly confused by your words. By Cryo do you mean rf?

[kalim123]

which drugs you have tried so far , in what dosage ??

[curmudgen]

Cryo - see web page - http://en.wikipedia.org/wiki/Cryoablation

[tom_h]

Lookup forum member Donna4140.  She just underwent cryogenic ablation 2 weeks ago.

[tom_h]

I Also wanted to mention that cryo ablation isn't better, but is an alternative. You get one chance with RF ablation.  Cryo allows testing the spot by chilling it and temporarily deactivating it before freezing and killing the problem tissue.

[merileegal]

Sorry about the terms rf and cryo. Radiofrequency and cryoablation are both effective, but there is evidence that cryoablation is safer in some circumstances. Here is a site I found that explains it in terms I understood. http://www.heartracing.com/patients/rf.vs.cryoablation.asp
Hope this helps as well as the info curmugden gave you.

[BobRBob]

I asked my EP about cryo vs rf and he said he doesn't use cryo because he doesn't like having to go in twice when once would suffice.

Pretty much to the point.

[heart2222]

I am wondering about this exact thing-cryo vs heat. It appears the results are conflicting as to which one is better. I do like the article about they can freeze areas and if those areas aren't causing the AF, they let them thaw and the area of the heart is perfectly functioning again. Since Cryo is relatively new, I wonder if more experience with this technique will show whether it is superior to heat?

Maybe it depends on the patient's individual needs as to which one is best??

Very confusing...

[michellepetkus]

From what I understand it is becoming more common to use freezing/cryo to initially test the site to ablate avnrt so that the node isn't completely blocked, which they can tell right away, but then use RF to do the actual ablation since it is more effective but I am not sure that theory would work for afib which involves a substantially larger amount of ablation points to correct the arrhythmia and you won't really know if it worked for some time.  I thought I read that initially the success rates are equal for both kinds but over time RF is more effective in the long run but some research may be in order.

[tom_h]

In October of 2010, when I began to explore the possibility of ablation, I questioned the possibility of cryogenic method with my chosen electrophysiologist.  His answer was pretty much the same as BobRBob posted above.  He told me that he prefers using the RF method wherever possibile as the burn is deeper and the the scar is better which creates fewer returns.  He only used cryo only in locations where he absolutely had to.

I think you're right, it depends on the individual's needs.  If you put your trust in the electrophysiologist, it's not confusing at all.  Let him make the decision.