Your heart normally beats in a steady rhythm controlled by electrical signals. Sometimes extra electrical pathways or irritable areas cause your heart to beat too fast or irregularly—conditions like atrial fibrillation or supraventricular tachycardia. While medications can control these rhythms, they don’t cure them and must be taken daily. Cryoablation offers a permanent solution by freezing the abnormal tissue causing the problem.
Overview
Cryoablation fixes abnormal heart rhythms by freezing problematic tissue. A special catheter with a tip that becomes extremely cold is positioned at the source of abnormal electrical signals and destroys that tissue through freezing.
The catheter tip cools to around -70 to -80°C (-94 to -112°F), cold enough to freeze and kill heart cells. The frozen tissue forms small scars that can’t conduct electricity, blocking the abnormal signals that were causing rhythm problems.
The key advantage over heat-based ablation is safety. When you freeze tissue, you can test the effect before making it permanent. If freezing that spot causes problems—like slowing your heart rate too much—you simply stop and the tissue recovers within seconds. This makes cryoablation particularly useful near important structures like your heart’s natural pacemaker.
Cryoablation is commonly used for atrial fibrillation—the most common abnormal rhythm where upper chambers beat chaotically—and supraventricular tachycardia where your heart suddenly races. Success rates are high, often curing the problem in 80-95% of cases depending on the specific rhythm.
The procedure takes 2-4 hours. You’re sedated or under general anesthesia, so you don’t feel anything. Most people go home the next day and return to normal activities within a week. Many never need rhythm medications again.
The Procedure
You’re brought to the electrophysiology lab—a specialized room with X-ray equipment and monitoring systems. An IV line is placed and you’re given sedation or put under general anesthesia.
Small punctures are made in veins in your groin or neck. Thin, flexible catheters are inserted through these punctures and threaded through your blood vessels to your heart using X-ray guidance. You don’t feel catheters moving through vessels.
Mapping catheters record electrical activity from inside your heart chambers. These create detailed maps showing exactly where abnormal signals originate. Sometimes doctors need to trigger your abnormal rhythm artificially to see precisely what’s happening.
Once the problem area is identified, the cryoablation catheter is positioned at that exact spot. The catheter tip begins cooling to extremely cold temperatures. Freezing happens quickly—within seconds the tip reaches -70 to -80°C.
For atrial fibrillation, a special balloon catheter is often used. This balloon positions at the opening where pulmonary veins connect to your heart’s upper left chamber—the most common source of abnormal signals in atrial fibrillation. The balloon inflates and its surface cools, freezing tissue all the way around the vein opening. This electrically isolates the vein, preventing abnormal signals from reaching your heart.
For other rhythms, a standard catheter tip freezes one small spot at a time. Each freeze application lasts several minutes. The doctor watches how the tissue responds. If everything looks good, they continue freezing until that spot is permanently destroyed. Multiple spots might need freezing to block the abnormal pathway completely.
During freezing, you typically don’t feel anything, though some people experience brief chest discomfort or a pulling sensation.
After ablation is complete, doctors test your heart’s electrical system. They try to trigger the abnormal rhythm again—if they can’t, the ablation succeeded. Sometimes they pace your heart at different speeds to make sure everything works normally.
The catheters are removed. Pressure is applied to the puncture sites for 10-20 minutes to stop bleeding. Small bandages are placed over the sites.
You’re moved to a recovery area for monitoring. You must lie relatively flat for several hours to prevent bleeding from the puncture sites. Most people stay overnight and go home the next day.
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Reference: Cryo ablation
