ABOUT 'BEAT YOUR A-FIB'...


"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su Cavanaugh Heart Center, Phoenix, AZ

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"



ABOUT A-FIB.COM...


"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013


Dr. Ross J. Hunter

Combining RF and CryoBalloon Ablation Techniques, Do Success Rates Increase?

Ross-J Hunter

Ross J Hunter

Pulmonary Vein ablation (PVA), using RF point-by-point isolation, or using CryoBalloon technology? It is really a choice of one or the other?

What happens when you combine the two techniques? Do ablation success rates increase?

To answer these questions, UK researcher, Dr. Ross J. Hunter devised a single-center study to compare three different ablation strategies. He divided 237 Paroxysmal A-Fib patients undergoing their first ablation into three treatment groups.

Group 1 Strategy: standard RF point-by-point ablation of the Pulmonary Vein openings (PVs) using an irrigated tip catheter guided by a 3D mapping system.

Group 2 Strategy: CryoBalloon ablation using the Arctic Front CryoBalloon catheter, and if PV isolation wasn’t achieved using the CryoBalloon alone, RF focal lesions were added.

Group 3 Strategy: RF point-by-point ablation followed by two applications of the CryoBalloon.

Success Rates After One Year

Group 1:  At one year 47% were A-Fib free and off of all antiarrhythmic drugs; (This is a relatively low success rate compared to some centers using RF ablation.) Average procedure time was 211 minutes;

Group 2:  The one year success rate was 67% (significantly better than the RF group); Important Note: In addition to the CryoBalloon, 31% needed RF focal lesions to achieve PV isolation. Average procedure time was 167 minutes;

Group 3: After one year the success rate was 76% which was better than the CryoBalloon alone, but the difference wasn’t ‘statistically significant’ (meaning it could have occurred by chance). Average procedure time was 278 minutes.

The Study Results: How the Three Strategies Compare

Best result: Group 2 Strategy:CryoBalloon plus RF lesions as needed strategy’. It was faster, easier to use and was more effective after one year than the Group 1 strategy ‘RF point-by-point ablation’.

Disappointing result: Using the novel Group 3 strategy of combining ‘RF ablation followed by CryoBalloon ablation’ did not significantly improve results and took longer to do.

Most surprising result: When the authors designed this study, they thought the combined approach of ‘RF ablation followed by CryoBalloon’ (Group 3) would turn out to be superior to the other two strategies. Their prediction was wrong. It turned out it was only superior to ‘RF alone’  strategy (Group 1).

The Bottom Line

The take-away: About 30% of CryoBalloon ablations required RF focal lesions to achieve isolation of all A-Fib signals and to restore the patient to normal sinus rhythm.

What This Means for A-Fib Patients

For the best results with a CyroBalloon ablaltion, you want an electrophysiologist (EP) who is not only experienced with CryoBalloon, but who can also use RF technology when needed to map and isolate A-Fib signals originating beyond the pulmonary veins.

Finding the right EP: Be cautious. With the advent of CryoBalloon ablation, some EPs with little or no expertise with RF ablations are now doing CryoBalloon ablations. Why? Because they’re easier to perform. As a patient, you want to stay away from EPs who only do CryoBalloon ablation.

Here’s an example why:

Recently a patient, still in A-Fib, sent me the O.R. (Operating Room) report of their CryoBalloon ablation. From reviewing the report, it appears the EP didn’t make any attempt to map and isolate non-Pulmonary Vein (PV) triggers, and simply shocked the patient to return him to normal sinus rhythm. This may work in some cases. But for this patient the ablation was a failure.

Most experienced EPs who have switched from performing RF ablations to CryoBalloon ablations have the ability, skill and experience when needed to use RF technology to isolate non-PV triggers when needed.

Questions to Ask Prospective EPs: to find the right EP for your CryoBalloon ablation ask:

What do you do if I’m still in A-Fib after you do the CryoBalloon ablation?
Will you use RF techniques to get me back into normal sinus rhythm?

(You want an EP who answers ‘yes’ to the second question.)

References for this article

Combining RF and CryoBalloon Ablation Techniques, Do Success Rates Increase?

Research Findings

Combining RF and CryoBalloon Ablation Techniques, Do Success Rates Increase?

by Steve S. Ryan, PhD

Ross-J Hunter

Ross-J Hunter

Pulmonary Vein ablation (PVA), using RF point-by-point isolation, or using CryoBalloon technology? It is really a choice of one or the other?

What happens when you combine the two techniques? Do ablation success rates increase?

To answer these questions, UK researcher, Dr. Ross J. Hunter devised a single-center study to compare three different ablation strategies. He divided 237 Paroxysmal A-Fib patients undergoing their first ablation into three treatment groups.

Group 1 Strategy: standard RF point-by-point ablation of the Pulmonary Vein openings (PVs) using an irrigated tip catheter guided by a 3D mapping system.

Group 2 Strategy: CryoBalloon ablation using the Arctic Front CryoBalloon catheter, and if PV isolation wasn’t achieved using the CryoBalloon alone, RF focal lesions were added.

Group 3 Strategy: RF point-by-point ablation followed by two applications of the CryoBalloon.

Success Rates After One Year

Group 1:  At one year 47% were A-Fib free and off of all antiarrhythmic drugs; (This is a relatively low success rate compared to some centers using RF ablation.) Average procedure time was 211 minutes;

Group 2:  The one year success rate was 67% (significantly better than the RF group); Important Note: In addition to the CryoBalloon, 31% needed RF focal lesions to achieve PV isolation. Average procedure time was 167 minutes;

Group 3: After one year the success rate was 76% which was better than the CryoBalloon alone, but the difference wasn’t ‘statistically significant’ (meaning it could have occurred by chance). Average procedure time was 278 minutes.

The Study Results: How the Three Strategies Compare

Best result: Group 2 Strategy:CryoBalloon plus RF lesions as needed strategy’. It was faster, easier to use and was more effective after one year than the Group 1 strategy ‘RF point-by-point ablation’.

Disappointing result: Using the novel Group 3 strategy of combining ‘RF ablation followed by CryoBalloon ablation’ did not significantly improve results and took longer to do.

Most surprising result: When the authors designed this study, they thought the combined approach of ‘RF ablation followed by CryoBalloon’ (Group 3) would turn out to be superior to the other two strategies. Their prediction was wrong. It turned out it was only superior to ‘RF alone’  strategy (Group 1).

The Bottom Line

The take-away: About 30% of CryoBalloon ablations required RF focal lesions to achieve isolation of all A-Fib signals and to restore the patient to normal sinus rhythm.

What This Means for A-Fib Patients

For the best results with a CyroBalloon ablaltion, you want an electrophysiologist (EP) who is not only experiened with CryoBalloon, but who can also use RF technology when needed to map and isolate A-Fib signals originating beyond the pulmonary veins.

Finding the right EP: Be cautious. With the advent of CryoBalloon ablation, some EPs with little or no expertise with RF ablations are now doing CryoBalloon ablations. Why? Because they’re easier to perform. As a patient, you want to stay away from EPs who only do CryoBalloon ablation.

Here’s an example why:

Recently a patient, still in A-Fib, sent me the O.R. (Operating Room) report of their CryoBalloon ablation. From reviewing the report, after ablating the Pulmonary Veins (PV), it appears the EP didn’t make any attempt to map and isolate non-PV triggers. When the patient didn’t return to normal sinus rhythm on his own, the EP simply cardioverted the patient back into normal sinus rhythm. This may work in some cases. But for this patient the ablation was a failure.

Most experienced EPs who have switched from performing RF ablations to CryoBalloon ablations have the ability, skill and experience when needed to use RF technology to isolate non-PV triggers when needed.

Questions to Ask Prospective EPs: to find the right EP for your CryoBalloon ablation ask:

What do you do if I’m still in A-Fib after you do the CryoBalloon ablation?
Will you use RF techniques to get me back into normal sinus rhythm?

(You want an EP who answers ‘yes’ to the second question.)

References for this article

A Must Read, if You Are Considering a CryoBalloon Ablation…

CryoBalloon catheter

CryoBalloon catheter

Question: What happens when you combine CryoBalloon and RF ablation techniques? Do success rates increase?

To find out, UK researcher, Dr. Ross J. Hunter devised a single-center study to compare three different ablation strategies. He divided 237 Paroxysmal A-Fib patients undergoing their first ablation into three treatment groups.

Group 1 Strategy: standard RF point-by-point wide of the Pulmonary Vein openings (PVs) using an irrigated tip catheter guided by a 3D mapping system.

Group 2 Strategy: CryoBalloon ablation using the Arctic Front CryoBalloon catheter, and if PV isolation wasn’t achieved using the CryoBalloon alone, RF focal lesions were added.

Group 3 Strategy: RF point-by-point ablation followed by two applications of the CryoBalloon.

Read my new research report and learn what the findings mean if you are considering a CryoBalloon ablation. See Combining RF and CryoBalloon Ablation Techniques, Do Success Rates Increase?

By Combining RF and CryoBalloon Ablation Techniques, Do Success Rates Increase?

Research: Combining RF and CryoBalloon Ablation Techniques

Combining RF and CryoBalloon Ablation Techniques

Research Findings

By Combining RF and CryoBalloon Ablation Techniques, Do Success Rates Increase?

RF point-by-point ablation for Pulmonary Vein (PV) isolation is technically challenging, time consuming, and the first-time success rate is variable. CryoBalloon ablation is easier and faster.

Question: What happens when you combine the two techniques? Do success rates increase?

To find out, UK researcher, Dr. Ross J. Hunter devised a single-center study to compare three different ablation strategies. He divided 237 Paroxysmal A-Fib patients undergoing their first ablation into three treatment groups.

Group 1 Strategy: standard RF point-by-point wide of the Pulmonary Vein openings (PVs) using an irrigated tip catheter guided by a 3D mapping system.

Group 2 Strategy: CryoBalloon ablation using the Arctic Front CryoBalloon catheter, and if PV isolation wasn’t achieved using the CryoBalloon alone, RF focal lesions were added.

Group 3 Strategy: RF point-by-point ablation followed by two applications of the CryoBalloon.

Success Rates After One Year

Group 1:  At one year 47% were A-Fib free and off of all antiarrhythmic drugs; (This is a relatively low success rate compared to some centers using RF ablation.) Average procedure time was 211 minutes;

Group 2:  The one year success rate was 67% (significantly better than the RF group); Important Note: In addition to the CryoBalloon, 31% needed RF focal lesions to achieve PV isolation; Average procedure time was 167 minutes;

Group 3: After one year the success rate was 76% which was better than the CryoBalloon alone, but the difference wasn’t ‘statistically significant’ (meaning it could have occurred by chance); Average procedure time was 278 minutes.

How the Strategies Compare

In this single center study, the CryoBalloon plus RF lesions as needed strategy (Group 2) was faster, easier to use and was more effective after one year than RF point-by-point ablation approach (Group 1). Using the novel strategy of combining RF followed by CryoBalloon ablation (Group 3) did not significantly improve results and took longer to do.

Editor’s Comments:
When the authors designed this study, they thought the combined approach of RF followed by CryoBalloon (Group 3) would turn out to be superior to either RF alone or CryoBalloon with RF as needed. But the combined RF followed by CryoBalloon strategy was only superior to RF alone (Group 1).
Key Result for Patients: The most important finding of this study is that about 30% of CryoBalloon ablations required RF focal lesions to achieve isolation (and restore normal sinus rhythm).
CryoBalloon ablation is very effective. But for the best results, you want an EP who is not only experienced with CryoBalloon, but also, when needed, can use RF to map and isolate non-PV triggers.
Be cautious. With the advent of CryoBalloon ablation, some EPs with little or no expertise with RF ablations are now doing CryoBalloon ablations because they’re easier. Stay away from EPs who only do CryoBalloon ablation.
For example, recently a patient, still in A-Fib, sent me the O.R. (Operating Room) report of their CryoBalloon ablation. From reviewing the report, it appears the EP didn’t to make any attempt to map and isolate non-PV triggers, and simply shocked the patient to return him to normal sinus rhythm. This may work in some cases. But for this patient the ablation was a failure.
Most experienced EPs who have switched from RF to CryoBalloon ablation have the ability, skill and experience to use focal point RF as needed to make you A-Fib free.
Seek out these experienced EPs by asking “What do you do if I’m still in A-Fib after you do the CryoBalloon ablation? Will you use RF focal lesions to achieve isolation?”
References for this article

Follow Us
facebook block 65 pix REVtwitter block 65 pixlinkedin block 65 pixpinterest.block 65 pix


A-Fib.com is a
501(c)(3) Nonprofit



Your support is needed. Every donation helps, even just $1.00.


We Need You
A-Fib.com Mission Statement
BYA - Alerts ad Green

A-Fib.com top rated by Healthline.com for the third year.
A-Fib.com top rated by Healthline.com for the third year. 2014  2015  2016

Mug - Seek your cure - Beat Your A-Fib 200 pix wide at 300 resEncourage others
with A-Fib
click to order

Home | The A-Fib Coach | Help Support A-Fib.com | A-Fib News Archive | Tell Us What You think | Media Room | GuideStar Seal | HON certification | Disclosures | Terms of Use | Privacy Policy