Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
I had a talk with my EP a couple months ago and I thought he was doing cryoballon ablations these days since he was the first doctor in our area to do the procedure.
To my surprise, he said he switched back to RF ablations because he said it had the same risks as cryoballon and in some cases fewer risks, and was equally as effective as cryoballon ablations.
To me, this flies in the face of just about everything I've read on this topic. Cryoballon is supposed to be safer and more effective. This doctor does over 200 procedures per year so he would know I guess, but I'm curious what others think.
If you've had an ablation, which one did you have and why? If you were to have one, which one would you do and why?
Travis
To my surprise, he said he switched back to RF ablations because he said it had the same risks as cryoballon and in some cases fewer risks, and was equally as effective as cryoballon ablations.
To me, this flies in the face of just about everything I've read on this topic. Cryoballon is supposed to be safer and more effective. This doctor does over 200 procedures per year so he would know I guess, but I'm curious what others think.
If you've had an ablation, which one did you have and why? If you were to have one, which one would you do and why?
Travis
I had an ablation last December. My EP used both RF and Cryo. He told me before the ablation that some areas (like pulmonary arteries) are better and faster with Cryo. He said because of the shape of the Cryo balloon, he might NOT be able to ablate the entire desired area. Then, he ablates the missed areas with RF catheter. Also, some areas are better to be ablated just with RF. He said he makes the decision for RF or Cryo during the ablation process as he sees which one fits better.
Definitely, the RF/Cryo ablation is a lot faster than RF only ablation. However, the hospital must have the equipment for Cryo too. My EP told me a lot of hospitals do NOT have the equipment for Cryo (too expensive). As a result, the EP must perform RF only ablation.
In your case, may be the hospital is not supporting the Cryo ablation any more. So, your EP has to go to RF only ablation. Or, may be there is new unfavorable data out about Cryo. I am not sure.
Good luck and hopefully you don't need ablation at all.
Scott
http://a-fib.com/treatments-for-atrial-fibrillation/catheter-ablation/a-cryo-ablation-primer/
petey
I would say that it all comes down to the confidence you have in your EP. I had the laser balloon ablation in January of 2013, simply due to the fact that my EP (Dr. Hugh Calkins, Johns Hopkins) indicated that in his opinion, it had a 90% chance of success. From the little research I did on it, it seemed to me that this type of ablation would be THE go to ablation...but I haven't heard a thing about it, other than Dr. Natale gave upon it. So I think that unless you have mad skills at doing research, it comes down to trusting your EP. So many options for ablations these days! Best of luck in making your final decision!
Bill
@Bill - laser ablation? I've never heard of that procedure. I'll have to look into it.
Travis
Cardiofocus laser balloon ablation. They have been doing it in France for over 10 years. I was in the study at Johns Hopkins...dunno if there are other studies going on right now or not. But when Dr. C said that it has a 90% chance of success, I went for it! I still have palpitations and the occasional 2 or 3 second run of tachacardia, but I was told that this has nothing to do with the ablation. It is amazing to read about all the ablation options out there...tough decision to make. As many here have said, I think that the EP is more important than the method. Get a superstar, and it greatly increases your chance of success.
Bill
My 3rd was RF and I asked about the CRYO. If I remember correctly, studies shows there was no differences in successful outcomes between them thus reverting back to the cheaper RF.
When I had my CRYO back in SEP 2011, I went to the MFG's web site and watched their video. I thought it was impressive, that you could isolate the PV's with little effort. Thus you don't have to 'connect the dots.'
In my opinion, it boils down to where the nodes are AFIB-ing...If they are up in the PV region, CRYO would do better. IF they are below the atria-PV junction, then RF is better.
But then again, I've been zapped so much, I may have wiped my memory!
Robert
What was the recovery like for the RF vs cryoballon? Was one easier or less painful or was it about the same? And obviously neither one worked but did one work better than the other?
I hope the 3rd procedure is working out for you. I hate hearing that when people need more than one procedure. It sucks that they haven't found a procedure that has a higher success rate with one procedure. Wouldn't it be great if ablations were closer to 90% success rates after one attempt? Maybe some day.
Speaking of 90% success rates, Bill, I'm very intrigued by the laser procedure. It's on my list to do further research. 90% success rates sound very good to me!
Travis
Now I am curious...I was wondering if the results of the study had been published yet. I found this entry on Yahoo about a conference they held in California regarding this. Sorry I cannot post the link, as I am computer illiterate...I do know enough to do cut and paste, so here is a little bit of the info. The study I was in started in late 2012 (I got my ablation 2 January 2013) so I would think at least preliminary results would be in....but I don't know anything about medical protocol. How long do they usually take to publish initial results? In any case, hopefully soon something regarding this method will be published...of course, I will be freaked out if they said "Success rate thusfar has been one dude in Maryland, everyone else's heart has exploded!"
MARLBOROUGH, Mass., May 5, 2014 /PRNewswire/ -- CardioFocus, Inc., developer of the HeartLight Endoscopic Ablation System for the treatment of atrial fibrillation (AF), today announced that recent data will be presented at two major conferences focusing on cardiac rhythm management, the 2014 Stanford Biodesign New Arrhythmia Technologies Retreat, being held May 6th in Stanford, CA., and 2014 Heart Rhythm Society (HRS) Scientific Sessions, being held May 7-10 in San Francisco, CA.
Still searching for results!
Bill
Hold LEFT button down
Highlight the URL at the top of page
Hit right button
Click on COPY
Start a message on DS Afib Support
Hit right button while in body of message
Click on Paste
:-)
petey
My EP chose Cyro because he felt it was safer---especially for women.
D.
Thanks for the site which compares Cryo vs. RF ablation. That is a very great reference. Member should bookmark it.
After reading the advantages/disadvantages of the two procedures, I definitely want my EP performs both for the best results. That is what I got during my ablation fortunately. I remember my EP was telling me a lot of the points in the article 2 days before the ablation over the phone.
It seems to me, IN GENERAL, ablations with combination of both methods (Cryo and RF) are more successful than with one or the other only. That is only based on my observation. So, if I was due for an ablation, I would make sure my EP performs both for the best results. Also, I would want to go with a procedure that has been around for at least for several years so all the KINKS are out of it.
I never buy a new model car when it comes out in its first year. As a technical person, I know there is no perfect new thing or procedure. In every new thing just out, there are lots of kinks, which come out after being used by lots of users. Another good example of what I am trying to say is Microsoft Windows, which are DOGS in their first year of release. The same is going to be true for new ablation techniques.
I think Bill was brave and trusting to go with Laser Balloon ablation, which was brand new. Fortunately, it did NOT turn out like Windows 8 when it just came out, remember that? :-) More power to you, Bill.
Bottom line -
In my opinion, if you are in the market for an ablation, go with something which has been practiced for several years for the best outcome. Also, going with Cryo/RF combo ablation may be the best at this time until other methods get some mileage UNLESS you are a LUCKY person in life and always win in Las Vegas. I have seen lucky people who always won. I am NOT one of them :-)
Just food for thoughts.
Scott
Recover on RF vs. CRYO was essentially the same.
What MADE a significant difference, was that after the first one, i did not get an IV Tylenol. I spoke to the AN who said they use to give it 2 hours before someone gets off the table. SO he gave it to right before i went into recovery.
Bottom line: I'd requested the IV Tylenol and was give for the 3rd. I could take a long time to describe, but between #1 w/o, and #2 with, #1 i was in significant pain for half a day, but #2, i was resting comfortable.
Note the AN mentioned they use to give it 'routine' but the cost was too high for routine... thus i asked for it.
Robert
PS: Sorry to delay response, i've been away for a while, and leaving again for CA on Monday.