Cryoablation procedure proves effective for treating atrial fibrillation F o r patients suffering with the symptoms of atrial fibrillation (AFib), a new cryoablation procedure produces positive YOURCRYOBALLOON PROCEDURE Cryoballoon Ablation Procedure U O ryoballoon lation Procedure R PR DURE ry all l ti r ce re ll l Medtronic
outcomes and improves quality of life. NCH clinical cardiac electrophysiologist, Philip George, MD, describes AFib as a condition whereby disorganized rhythms in the top chambers of the heart cause a fast heart rate and irregular beats, oftentimes resulting in palpitations or a pounding heart. Left untreated AFib can worsen over time. Dr. George says that with some patients, AFib can lead to heart failure symptoms, lower extremity swelling or difficulty breathing when not sitting up. These patients also have an increased risk of blood clots and stroke. While some patients with AFib are completely asymptomatic, others report fatigue, shortness of breath, dizziness, light-headedness or chest pressure. “If symptoms are primarily driven by the heart rates, we control the rates and the patient feels better,” explains Dr. George. “But if symptoms are driven by the fact that you are actually in AFib, then our goal is to get you out of AFib.” According to Dr. George, the NCH Heart Institute uses antiarrhythmic medications specially formulated to help suppress AFib. However, some patients, even those on a stable dose of medications, can still periodically have breakthrough of AFib while taking antiarrhythmic medications. Apart from medication, ablation, a minimally invasive catheter-based procedure, is utilized when indicated. The two types are the newer cryoablation used mainly for first time ablation and paroxysmal AFib, and radiofrequency ablation which can be used for all types of AFib and more persistent forms. Radiofrequency ablation was the initial treatment designed to treat heart rhythm disturbances. The ablation procedures to correct heart rhythm disturbances generally treat abnormal areas of tissue that are responsible for causing the heart rhythm disturbances. “In the ablation procedures, we insert a catheter in the vein of the groin and advance the catheter up to the heart,” says Dr. George. “In the cryoablation, we freeze tissue to create scar tissue, whereas in radiofrequency ablation, a catheter that heats the tissue is used to create scar tissue.” Cryoablation candidates with the best outcomes are those who are newly diagnosed undergoing initial ablation for paroxysmal AFib– which are alternating episodes of normal rhythm and episodes of AFib. Dr. George adds that while we can still do cryoablations in persistent AFib patients, radiofrequency ablation is typically recommended for those patients. Cryoablation and radiofrequency ablation are also performed by NCH clinical cardiac electrophysiologist Dr. Dinesh Sharma. doctor immediately ab ut any changes in your health. You may be under general anesthesia for the procedure. After You will need to limit your activities for a couple of days. Minor soreness in the chest or bruising at the insertion site is normal. Let your physician know if you xperience any symptoms th t are bothering you. Your doctor will probably arrange follow-up visits to monitor your healing and heart rhythms. Your doctor will probably tell you not to eat or drink after idnight the night before your procedu eed to stop ant to tell your doctor i ediately about any hanges n r health. You ay be under general ane thesia for the procedure. fter You will need to li it your activities for a e chest s g si n c f o p sy pto s that are bothering you. tor will probably arrange follow-up visits our healing and e Y ur d ct r ill pr bably tell y n t t eat r drink after idnight the night bef re y ur pr cedure. You may need t st p certain medications. You will also want t tell y ur doctor i ediately ab ut any changes in your health. Y u ay be under general anesthesia f r the pr cedure. ft r Y u ill need t li it y ur activities f r a couple of days. Minor soreness in the chest or bruising at the insertion site is normal. Let your physician know if you experience any sy pt s that are b thering y u. Your d ct r ill pr bably arrange f ll -up visits to monitor y ur healing and heart rhythms. Dr. Philip George Your doctor will discuss your procedure with you in detail, but here is a general overvi w of what you can expect. Before Your doctor will probably tell you not to eat or drink after midnight the night before your procedure. You may need to stop certain medications. You will also want to tell your Your doctor will discuss your pro edure with you in detail, but here is a general overview of what you can expect. Before Y ur d ct r ill discuss y ur pr cedure ith y u in detail, but here is a general vervie f hat y u can expect. f r
Access The doctor makes a small incision in the groin area through which to insert the catheter (small tube). To access the left atrium, the doctor must create a puncture in the wall that separates the left and right sides of the heart. The cryoballoon is then advanced to the left atrium. Access The doctor akes a s all incision in the groin area through which to insert the catheter (s all create a puncture in the wall that separates the left and right sides the heart. The cryoballoon is then advanced to the left atriu . ccess he doctor akes a s all incision in the groin area through hich to insert the catheter (s all tube). To access the left atrium, the doctor must create a puncture in the wall that separates the left and right sides of the heart. he cryoballoon is then advanced to the left atriu . A T l i i i i t r in r through which to insert t c t t ( ll t ). l i , t r m st t punct i t wall that separates the l ft right sides of t h rt. T lo i t vanced to t left atriu .
Inflate The doctor inflates the balloon and moves it to the opening of the pulmonary vein. The goal is to temporarily close off the opening of the pulmonary vein completely, stopping blood flow between the atrium and the vein (this is called occlusion). Inflate l the opening of the pul onary ve The goal is to te porarily close off the opening of the pul onary vein co pletely, stopping blood flow between the atriu and the vein (this is called occlusion). Inflate The doctor inflates the balloon and moves it to the opening of the pul onary vein. he goal is to te porarily close off the opening of the pul onary vein co pletely, stopping blood flo bet een the atriu and the vein (this is called occlusi ). t i l m ves it t l r v in. T l il cl f t l r v in c let ly, st ing bl od flow t i t v in (t is is c led l i ).
Freeze (Ablate) When occlusion is confirmed, the doctor introduces cold energy into the balloon. The cold energy freezes the tissue where the balloon touches the opening of the pulmonary vein. This scars the tissue, stopping the transmission of electrical signals that cause atrial fibrillation. Freeze (Ablate) hen occlusion is confir ed, the doctor introduces cold energy into the balloon. The cold energy freezes the tissue where the balloon touches the opening of the pul onary vein. This scars the tissue, stopping the trans ission of electrical signals that cause atrial fibrillation. Freeze ( blate) hen occlusion is confir ed, the doctor introduces cold energy into the balloon. he cold energy freezes the tissue here the balloon touches the opening of the pul onary vein. his scars the tissue, stopping the trans ission of electrical signals that cause atrial fibrillation. Freeze ( blate) hen occlusion is confir ed, the doc or introduces c ld energy into the balloon. The cold energy freezes the tiss e here t alloon touc the opening o he p lmo ry vein. is sc rs t ti sue, stopping the transmission of electric l signals that cause atrial fibrillation.
Cryoablation alleviates AFib symptoms such as: • Shortness of breath • Fatigue • Generalized weakness • Trouble breathing when lying prone
For more information, contact the NCH Heart Institute at (239) 624-4200.
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