Cryogenic balloon catheter ablation

Posted by tct @tct, Sep 14 6:23am

After 7 months on Eliquis & Metoprolol, I’ve scheduled an ablation in November, as recommended by my EP. Just wondering if anyone here on Mayo Connect has undergone this particular type ablation. Thanks!

Interested in more discussions like this? Go to the Heart Rhythm Conditions group.

No, but I am also considering an ablation soon and have started consults with several EP's and also patients. One close friend of mine recommended his EP very highly and claimed "perfect" results from a cryo-ablation now several years ago. While it appears that the cryo method is far less common than RF for cardiac ablations, I have been unable so far to find any hard data on outcomes and only one patient who had one as noted. The EP who performs them here in RI is well thought of generally and busy though. Like most surgical procedures, it appears that your choice of EP/Surgeon is the critical variable. The book "AFIB Cure" by John Day MD has a whole chapter on questions you should pose to your prospective EP and much insight on how to select one.

REPLY
@tedalmon

No, but I am also considering an ablation soon and have started consults with several EP's and also patients. One close friend of mine recommended his EP very highly and claimed "perfect" results from a cryo-ablation now several years ago. While it appears that the cryo method is far less common than RF for cardiac ablations, I have been unable so far to find any hard data on outcomes and only one patient who had one as noted. The EP who performs them here in RI is well thought of generally and busy though. Like most surgical procedures, it appears that your choice of EP/Surgeon is the critical variable. The book "AFIB Cure" by John Day MD has a whole chapter on questions you should pose to your prospective EP and much insight on how to select one.

Jump to this post

Just had my second cryo-ablation two days ago– First was performed in January 2022 which is apparently successful (pulmonary veins). Second was required for Atrial Flutter in the right atrium but while in there mapped the heart and found two other areas in the left that he did also. Was as outpatient – procedure was about three hours with recovery about the same and all is well at this time. IN at 11:30 (1 hour of prep) 12:30 surgery and home by 6:30.

REPLY
@warbru

Just had my second cryo-ablation two days ago– First was performed in January 2022 which is apparently successful (pulmonary veins). Second was required for Atrial Flutter in the right atrium but while in there mapped the heart and found two other areas in the left that he did also. Was as outpatient – procedure was about three hours with recovery about the same and all is well at this time. IN at 11:30 (1 hour of prep) 12:30 surgery and home by 6:30.

Jump to this post

That was great, thanks. Any other factors that may have weighed on your decision to go the Cryo route would be interesting. Was it simply the way your EP was most comfortable doing it?

REPLY
@tedalmon

No, but I am also considering an ablation soon and have started consults with several EP's and also patients. One close friend of mine recommended his EP very highly and claimed "perfect" results from a cryo-ablation now several years ago. While it appears that the cryo method is far less common than RF for cardiac ablations, I have been unable so far to find any hard data on outcomes and only one patient who had one as noted. The EP who performs them here in RI is well thought of generally and busy though. Like most surgical procedures, it appears that your choice of EP/Surgeon is the critical variable. The book "AFIB Cure" by John Day MD has a whole chapter on questions you should pose to your prospective EP and much insight on how to select one.

Jump to this post

Ted, here's a 2021 trial with 203 patients.
– Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation: https://www.nejm.org/doi/full/10.1056/NEJMoa2029554

Excerpt:
"In this randomized, multicenter trial, the initial use of cryoballoon ablation was superior to drug therapy for the prevention of atrial arrhythmia recurrence, with 75% of patients in the cryoballoon group and 45% of patients in the drug-therapy group having treatment success at 12 months."

@tct, did you see @warbru's helpful post? What questions do you have about cryoballoon ablation?

REPLY
@colleenyoung

Ted, here's a 2021 trial with 203 patients.
– Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation: https://www.nejm.org/doi/full/10.1056/NEJMoa2029554

Excerpt:
"In this randomized, multicenter trial, the initial use of cryoballoon ablation was superior to drug therapy for the prevention of atrial arrhythmia recurrence, with 75% of patients in the cryoballoon group and 45% of patients in the drug-therapy group having treatment success at 12 months."

@tct, did you see @warbru's helpful post? What questions do you have about cryoballoon ablation?

Jump to this post

Mostly, just curious as to others experience with this procedure. For instance did they need a repeat ablation?; were they able to stop medication?; did it stop PVC’s and SVT’s?

REPLY
@warbru

Just had my second cryo-ablation two days ago– First was performed in January 2022 which is apparently successful (pulmonary veins). Second was required for Atrial Flutter in the right atrium but while in there mapped the heart and found two other areas in the left that he did also. Was as outpatient – procedure was about three hours with recovery about the same and all is well at this time. IN at 11:30 (1 hour of prep) 12:30 surgery and home by 6:30.

Jump to this post

still have to take metoprolol and Eliquis afterwards?

REPLY
@colleenyoung

Ted, here's a 2021 trial with 203 patients.
– Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation: https://www.nejm.org/doi/full/10.1056/NEJMoa2029554

Excerpt:
"In this randomized, multicenter trial, the initial use of cryoballoon ablation was superior to drug therapy for the prevention of atrial arrhythmia recurrence, with 75% of patients in the cryoballoon group and 45% of patients in the drug-therapy group having treatment success at 12 months."

@tct, did you see @warbru's helpful post? What questions do you have about cryoballoon ablation?

Jump to this post

Colleen, thank you for the link to the study on cryoballoon ablation v. anti-arrhythmic drug therapy. It confirms the strong recommendations in "AFIB Cure" about having the procedure done earlier. I was first diagnosed with AFIB following/during hip replacement surgery now seven years ago, and while paroxysmal, it has become much more frequent and bothersome recently as records of my testing at Mayo-Jacksonville attest.

I have an appointment on November 10 with Melinda Barber APRN and I intend to make my case for having an ablation ASAP. I have not consulted directly with any EP at Mayo yet and I am concerned about the method they employ and their experience and outcomes with the procedure. It is quite plain to me that I should have considered this treatment sooner in the condition, but it was never recommended by my cardiologist, probably due to now outdated protocols suggesting drug treatment first, or technology advances in the safety and efficacy of the procedure. I'm ready now.

REPLY
@tedalmon

That was great, thanks. Any other factors that may have weighed on your decision to go the Cryo route would be interesting. Was it simply the way your EP was most comfortable doing it?

Jump to this post

it is my EP’s preferred method—

REPLY
@obdoc2001

still have to take metoprolol and Eliquis afterwards?

Jump to this post

Yes —- at least until we see how successful the procedure is

REPLY
@tedalmon

That was great, thanks. Any other factors that may have weighed on your decision to go the Cryo route would be interesting. Was it simply the way your EP was most comfortable doing it?

Jump to this post

EPS preferred method

REPLY
@warbru

Yes —- at least until we see how successful the procedure is

Jump to this post

if successful? then?

REPLY

Make a decision based on facts, risks, medical opinion etc. Remember it is always the patient’s ultimate choice on what to do regarding his/ her health.

REPLY
Please sign in or register to post a reply.
  Request Appointment