Treating Atrial Fibrillation with Cryoablation
Millions of people worldwide struggle with atrial fibrillation (AF). Current estimates show that AF affects 1 to 2% of the general population.
Experiencing shortness of breath, fatigue and dizziness is too often a persistent occurrence for those of us who suffer from this condition.
If you have AF, the chances are that it has had adverse effects on your quality of life, whether it be limiting the types of physical activity you enjoy, interfering with your work life or disrupting your sleep pattern. AF can also have a profound impact on your emotional health due to the anxiety and fears that go along with living with the disease.
If medications or cardioversion have failed to control your AF, what other options are available to you? Cryoablation for AFib is one treatment choice that is worth taking the time to consider carefully.
A multitude of research studies indicate that catheter ablation is the number one treatment choice for people who have recurrences of paroxysmal AF, accompanied with significant symptoms.
Standard cardiac catheter ablation uses radiofrequency (heat) energy to burn several tiny areas of tissue within the pulmonary vein that produce AF. The burned areas form scar tissue during the healing process, which creates an organic barrier that interrupts the incorrect electrical signal transmission that is triggering AF.
Cryoablation for AFib is a newer technique that uses cold energy to freeze the tissues in the pulmonary vein that produce the arrhythmia. The cold stimulus causes the same scar tissue to form as with the radiofrequency ablation, which leads to the same result.
What Are the Advantages of Cryoablation Versus Radiofrequency Ablation?
The downside of radiofrequency ablation is that the specialized cardiologist performing this procedure, called an electrophysiologist, must create a high number of burns; this makes the time needed to complete the process longer.
One advantage of cryoablation for AFib is that a single “shot" of energy can produce the desired results because the freeze of the tissue is circular. The electrophysiologist can use extra shots of cold energy if required.
Another benefit is that the scar tissue produced with cryoablation lasts longer than that formed from radiofrequency ablation. This helps preserve the natural structure of the material in the pulmonary vein. There is also less risk of blood clot formation when using cold energy as opposed to heat energy.
According to an article in the December 2017 issue of the Journal of Atrial Fibrillation, the complication rate with cryoablation is potentially less than with standard radiofrequency ablation.
What Are the Risks Associated with Cryoablation?
Some risks go along with any surgery, no matter how basic or complex the procedure is. The ones that you need to keep in mind if you are thinking about having cryoablation for your AF include:
- Pulmonary vein stenosis, which is a stiffening of the pulmonary vein
- Cardiac tamponade, which is the buildup of fluid within the membrane that surrounds the outside of the heart
- Heart attack
- Stroke
- Blood clot formation in your legs or lungs
- Infection or bleeding at the insertion site of the catheter
- A puncture in the wall of your heart
- Heart valve injury
- Damage to blood vessels that the catheter passes through to reach the area for the procedure
- Damage to your heart’s electrical system, which could make your AF worse and call for the placement of a permanent pacemaker
What Types of AF Can Cryoablation Treat?
Cryoablation is currently used to treat the type of AF known as paroxysmal.
Paroxysmal AF generally occurs without warning and can last up to seven days before it stops on its own. Sometimes it’s referred to as intermittent AF and it usually ends within 24 hours.
Currently, the technique is gaining interest as a possibly effective therapeutic option for people with persistent AF. Persistent AF lasts more than seven consecutive days and usually means your heart rhythm is no longer able to self-regulate.
However, there is not yet enough data from randomized controlled studies to conclusively determine whether cryoablation is a “best practice" strategy for treating this variety of AF. At present, researchers are hopeful that it will become a valid alternative to radiofrequency ablation in the future.
Is Cryoablation The Right Choice for Me?
If you have persistent AF that has not responded well to medications or cardioversion, cryoablation is an option for you to consider. Discuss your options with your cardiologist and find out what he or she recommends.
Your cardiologist is well-versed in your medical history and current condition and will know if you have any other issues that could be contraindications for cryoablation.
If you and your cardiologist agree that cryoablation is the best option, ask for a referral to an electrophysiologist with extensive experience in performing the procedure. The more cryoablation procedures the electrophysiologist and his or her team have completed, the lower your risk of experiencing complications.
Your cardiologist will know who and where to refer you to, ensuring the best possible outcome for you.
It’s a good idea for you and your family to research cryoablation for AFib ahead of time, so you are all familiar with the potential risks and benefits of the procedure. It’s also wise to seek out other people who have had the surgery so you can hear about their experience firsthand. That way, you will have a better idea of what to expect with both the technique and the recovery period.