Doctors & patients are saying about ''...

" is a great web site for patients, that is unequaled by anything else out there."

Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."

Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
Baltimore, MD

Doctors & patients are saying about 'Beat Your A-Fib'...

"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"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

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA

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 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
Dr. Ross J. Hunter is with St. Bartholomew’s Hospital, Bart Health NHS Trust & QMUL, London.

Hunter, Ross. Cryoballoon faster and more effective than conventional radiofrequency ablation for paroxysmal AF. Cardiac Rhythm News. Wednesday, May 14, 2014.—latest-news/cryoballoon-faster-and-more-effective-than-conventional-radiofrequency-ablation-for-paroxysmal-af

Published Jul 14, 2015

Related Posts

Follow Us
facebook - A-Fib.comtwitter - A-Fib.comlinkedin - A-Fib.compinterest - A-Fib.comYouTube: A-Fib Can be Cured! -

We Need You Help be self-supporting-Use our link to Amazon is a
501(c)(3) Nonprofit

Your support is needed. Every donation helps, even just $1.00. top rated by since 2014 

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