Cryoablation

Cryoballoon Used in Cryoablation of Atrial Fibrillation
Cryoballoon Used in Cryoablation of Atrial Fibrillation
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What is Cryoablation?

Cryoablation is a treatment for cardiac arrhythmias. It is performed to regulate the heart’s electrical system and prevent possible symptoms and complications. It is not a classical surgery but a minimally invasive method where thin catheters are sent to the heart through the groin. In this procedure, problematic tissues are frozen and deactivated using cold energy. It is generally performed using temperatures between -50 and -70 degrees. Cryoablation treatment can reduce or completely eliminate the need for medication. It is an effective treatment that significantly improves patients’ quality of life.

Why is Cryoablation Performed?

Cryoablation is performed to treat various arrhythmias. There are several important reasons why this method is preferred:

  • Its most common application is in atrial fibrillation, particularly effective in pulmonary vein isolation.
  • It’s a safer option in sensitive areas of the heart (for example, near the AV node).
  • Due to its temporary blocking feature, its effectiveness can be tested during the procedure.
  • It is generally less painful for patients.

How is Cryoablation Performed?

Cryoballoon and focal cryo are two different application methods of cryoablation technique. Focal cryo is designed to be a safer alternative in risky SVTs. Cryoballoon is performed with a balloon-shaped catheter designed to freeze the openings of vessels in atrial fibrillation and make ablation easier. While the names are similar, the procedures are entirely different.

Cryoballoon Method

This is a cryoablation method performed using a large, balloon-shaped catheter. It is particularly used for pulmonary vein isolation in the treatment of atrial fibrillation.

How it’s performed:

  • Patient is placed under sedation
  • Entry is made through the femoral vein
  • Cryoballoon is directed to the left atrium and then to pulmonary veins
  • The balloon is inflated at the pulmonary vein opening and full contact with the vein is ensured
  • Cold fluid is passed through the balloon, freezing the tissue it contacts
  • Usually, 2-3 minute freezing applications are performed for each vein
  • The procedure is repeated for each pulmonary vein (there are 4 vessels)

Advantage:

  • The main advantage of cryoballoon is providing large area treatment
  • Short procedure time

Focal Cryo Method

This is a cryoablation method applied using a smaller, precision catheter. It is used to target more specific and smaller areas, such as AVNRT, focal atrial tachycardia.

How it’s performed:

  • Patient is placed under sedation
  • Entry is usually made through the femoral vein
  • The source of arrhythmia is mapped in detail
  • Focal cryocatheter is directed to the target area
  • Catheter tip is brought into contact with target tissue and cooled
  • Usually, 2-4 minute freezing applications are performed
  • Applied to different points if necessary

Advantages:

  • Provides more precise and specific treatment
  • Safer near the AV node
  • Can be used in small and hard-to-reach areas

Cryoablation Procedure Duration and After

The procedure takes an average of 2-4 hours depending on the type of arrhythmia. Most patients can be discharged the next day. It is a preferred method with high success rates and safety, especially for certain types of arrhythmias. It offers permanent treatment potential and can reduce or eliminate medication use in many patients.

What are the Success Rates of Cryoablation?

Success rates vary. When performed by an experienced physician, success rates increase further. General rates are as follows:

  • Atrial Fibrillation (AFib): Cryoballoon ablation success rate is approximately 70-90%
  • Atrial Flutter: Success rate in typical atrial flutter is around 90-95%
  • AV Nodal Reentrant Tachycardia (AVNRT): Success rate is above 95%
  • Wolff-Parkinson-White Syndrome: Success rate is between 90-95%
  • Focal Atrial Tachycardia: Success rate is approximately 80-90%

Is Cryoablation Risky?

Cryoablation is a safe procedure. Side effects related to ablation are rare. Simple complications occur at a rate of 1%, while major complications occur at a rate of 0.1%, or one in a thousand. Bruising and swelling may occur at the entry site, in the groin area. During AF ablation, a small number of patients may experience paralysis in the right respiratory muscle (diaphragm). This is usually temporary. The rate of permanence is 0.1%. Stroke can rarely occur.

During AF ablation with cryoablation, gastroparesis may develop in a small number of patients during the procedure. This means increased stomach gas and decreased movements. It’s a simple condition and resolves shortly.

FAQs About Cryoablation

Is the patient put under anesthesia during cryoablation?

If it’s being performed for atrial fibrillation, it’s done under general anesthesia or deep sedation, while for SVTs it’s done under local anesthesia.

Is the cryoablation procedure painful?

Cryoablation is usually performed under sedation and most patients don’t feel pain. Mild discomfort may be felt after the procedure.

How long do I need to stay in the hospital?

Most patients can be discharged the same day or the next day. Usually, one overnight hospital stay is sufficient.

When can I return to normal life after the procedure?

Most patients can return to normal activities within a few days after cryoablation. Heavy exercise may need to wait for 1-2 weeks.

Which is better, cryoablation or radiofrequency ablation?

Both methods have their advantages. The choice of method depends on the type of arrhythmia and the patient’s specific condition.

Will I continue using medication after the procedure?

Many patients can reduce or completely stop medication use after cryoablation, but this should be done under doctor supervision.

How should I prepare for the procedure?

Generally, you’ll be asked to fast after midnight before the ablation. Some medications may be discontinued. You will be given specific instructions.

Is the procedure suitable for all types of arrhythmias?

Cryoablation is particularly effective in atrial fibrillation and certain supraventricular tachycardias, but may not be suitable for every type of arrhythmia.

What might I feel after the procedure?

After cryoablation, mild chest pain, burning sensation in the throat, and fatigue are common temporary effects.

Can cryoablation be repeated?

Yes, the procedure can be repeated if necessary. Some patients may need multiple procedures for optimal results.

Reference: Cryo ablation