Procedures

Cryoablation for the Treatment of Atrial Fibrillation

Cryoablation is an alternative therapy Massachusetts General Hospital Corrigan Minehan Heart Center physicians use to treat atrial fibrillation, a type of heart rhythm disorder. This minimally invasive procedure has the potential to reduce risk and minimize patient discomfort.

Doctors perform cryoablation to restore normal heart rhythm by disabling heart cells that create an irregular heartbeat. During this minimally invasive procedure, a thin flexible tube called a balloon catheter is used to locate and freeze the heart tissue that triggers an irregular heartbeat.

We have found that using cold, rather than heat, to disable damaged tissue reduces the chances of impacting healthy heart tissue and surrounding structures. Recent studies have found cryoablation to be significantly more effective than medication, and patients generally experience less pain than with radiofrequency ablation.

What Happens During Cryoablation?

A doctor inserts the balloon catheter into a blood vessel, usually in the upper leg, and then threads it though the body until it reaches the heart. This narrow tube has an inflatable balloon on one end that engages the pulmonary vein. Using advanced imaging techniques, the doctor is able to guide the catheter to the heart.

Once the balloon is at the ostium of the pulmonary vein, extreme cold energy flows through the catheter to destroy this small amount of tissue and restore a healthy heart rhythm.

What Is the Difference Between Heat-Based Ablation and Cryoablation?

Most patients are treated with heat-based ablation using radiofrequency (RF) catheters, but this procedure has some risk of complications, such as esophageal injury. Cryoablation helps physicians avoid these risks by using cold instead of heat to disable abnormal heart tissue. Unlike heat-based ablation, cryoablation allows physicians to cool tissue to make sure it is the area causing an irregularity. If it is not, the site’s normal electrical function can be restored simply by allowing the tissue to thaw and re-warm.

How Safe and Successful Is Cryoablation for Atrial Fibrillation?

The success rate of the procedure is generally very good, and depends on many factors, such as the duration of the condition, the presence of valve disease or coronary artery disease, the type of atrial fibrillation (paroxysmal or persistent) and the size of the atria.

However, like any other medical procedure, rare complications can occur. These complications include perforation of the heart, stroke, heart attack, narrowing of the pulmonary veins and bleeding at the entry site in the leg. Your physician will discuss all of these topics with you during your pre-procedure office visit.

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