Cryo-ablation for Irregular Heartbeat & Afib

Much in the way that heat can be harnessed to treat heart tissue that is sending erratic electrical signals, so too can the cold. That’s exactly what cryoablation uses to achieve the similar effect of disabling heart tissue and restoring normal heart rhythm. As discussed in the condition section of the website, arrhythmias, including the most common arrhythmia, Atrial Fibrillation or Afib, occur because electrical signals in the heart fire erratically.

We’ve also discussed medical therapy, which is often the first step in treating arrhythmias. Medication therapy is not considered durable, meaning it only lasts as long as the patient takes their medication, may have unacceptable side effects, and may diminish in effectiveness over time.

Over a decade ago, catheter-based technology was honed to allow for the effective treatment of arrhythmias using heat. More recently, we can now offer similar results using cold.

How the procedure works

Cardiac catheter cryo-ablation employs a small spaghetti-like tube, known as a catheter, that is inserted through a small incision in the groin. This tube is threaded up a blood vessel and to the heart, allowing for the deployment of specially-made, minimally invasive devices to perform the procedure. First, a balloon catheter is inflated and placed at the opening of the heart’s junction to the pulmonary vein.

Your electrophysiologist will then begin to cool the area and temporarily paralyze the heart tissue that may be causing irregular heartbeat. Real-time imaging technology is used to visualize the electrical patterns of the heart and offer a “preview” to determine if ablating that particular area will result in effective release. If that is the case, the area will be further cooled until the heart tissue is destroyed.

The result is effective in reducing or eliminating the errant electrical signals that may have caused the irregular heartbeat.

Benefits of Cryo-ablation

• As with catheter ablation, cryo-ablation is often curative for arrhythmias including Afib. This often avoids far more invasive procedures. In many cases, patients can discontinue, or at least reduce, their medication therapy and the side effects that go along with it.
• Cryo-ablation also reduces the risk of stroke in a some patients by eliminating the primary cause of blood pooling in the left atrial appendage.
• When compared to heat-based ablation techniques, cryo-ablation has the added benefit of previewing whether the ablation will be effective, by partially lowering the temperature, before the full ablation is performed. Heat-based ablation does not have the benefit of “testing the lay of the land,” so to speak.

Risks of Cryo-ablation

• As with any catheter-based procedure, there is the risk of damage to the blood vessels or the heart itself, which is rare in the hands of an experienced electrophysiologist.
• As with any procedure, there is the small risk of discomfort, bleeding or infection at the incision site. However, catheter-based procedures have the benefit of only requiring a tiny incision in the groin area, reducing this risk significantly.
• Patients undergoing a cryo-ablation may have a slightly increased risk of a cardiovascular event including a heart attack or stroke.
• Lastly, there is the risk that the ablation does not fully eliminate the arrhythmia and patients may be required to continue medical therapy, albeit often at a much lower dose. Patients may also require a touchup, or second procedure, to handle any recurrence.

The bottom line

Cryo-ablation, much like heat-based catheter ablation, is very effective in improving or eliminating irregular heartbeats including Afib. Doctors Niazi and Bisla are very experienced in both ablation procedures, and a consultation can help determine which procedure is best for your particular circumstance. We encourage you to contact our office and learn more about the procedures we offer.