Cryoablation uses extreme cold to destroy heart tissue that causes an irregular heartbeat, intending to restore a regular heart rhythm. Doctors may suggest cryoablation if other treatments do not work.

Atrial fibrillation (AFib) is a type of heart rhythm disorder that can cause symptoms such as heart palpitations, fatigue, and shortness of breath.

Doctors usually recommend medications or lifestyle changes to manage the heart’s rhythm. However, if these do not work, they may suggest minimally invasive procedures such as cryoablation.

This article explains cryoablation for AFib, including effectiveness, risks, recovery expectations, and other treatment options.

A doctor placing a sample into a cold cannister when using cryoablation to treat AFib.-2Share on Pinterest
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Cryoablation is a procedure that uses extreme cold on targeted areas inside the body.

Doctors may suggest it as an alternative to other treatments. These include medication and radiofrequency (RF) ablation, a similar procedure that uses RF energy to restore a typical heart rhythm.

Healthcare professionals may perform cryoablation with the person under light or deep sedation using local anesthetic. They insert a thin, flexible tube known as a catheter through a vein in the groin and carefully guide it into the heart.

Once the catheter reaches the heart, the electrophysiologist (a heart rhythm specialist) precisely maps the heart’s electrical signals. This mapping helps identify the areas of the heart that produce the abnormal electrical signals responsible for AFib.

The tip of the catheter has a balloon that inflates at the opening of the pulmonary veins — the veins that return oxygenated blood from the lungs to the heart.

The balloon emits extremely cold temperatures, creating scars or lesions on the tissue where abnormal electrical signals originate. These scars block those electrical pathways.

After the ablation, the electrophysiologist will check to ensure the abnormal signals are no longer present. Then, they remove the catheter and close and bandage the insertion site in the groin.

Current research suggests cryoablation may be an effective treatment for AFib. However, this effectiveness may vary depending on the type of AFib a person has.

According to a 2021 review, cryoablation has a relatively high success rate in people with paroxysmal AFib. It highlights a 2020 study of 203 adults with paroxysmal AFib.

The study randomly assigned patients treatment with antiarrhythmic medication or cryoablation. After 12 months, cryoablation was a successful treatment for around 74% of people, compared with 45% of people in the drug therapy group.

Another 2021 review highlights that cryoablation may be less successful for people with persistent AFib, which lasts longer than seven days. A person may need multiple procedures to see effective results.

Some people who undergo cryoablation may still experience AFib recurrence. More research is necessary to determine whether it is a better alternative than other techniques, such as RF ablation.

People having cryoablation treatment may have a small risk of bleeding or infection at the catheter insertion site.

A 2017 article highlights the following potential complications of cryoablation for AFib:

  • damage to blood vessels
  • cardiac tamponade — a rare complication in which blood enters the space around the heart, compressing it and impeding its ability to pump effectively
  • narrowing of the pulmonary veins, which carry blood from the lungs to the heart
  • injury to the phrenic nerve, which runs close to the heart and controls diaphragm movement
  • risks that relate to anesthetic

A 2021 article suggests that the risks of cardiac tamponade and fluid buildup in the pericardial sac around the heart are lower with cryoablation than RF ablation due to a lower chance of overheating.

However, the risk of phrenic nerve damage may be higher. There is also the possibility that cryoablation treatment will not be effective at treating AFib symptoms.

Doctors may discharge someone on the same day as treatment as long as there are no complications during the procedure.

However, they may wish to monitor certain people overnight before sending them home. In the first few hours after the procedure, a person may need to lie flat and minimize movement to reduce the risk of bleeding from the catheter insertion site.

After returning home, people may need to limit certain activities, such as heavy lifting or driving, until their doctor confirms it is safe. They may also need to avoid getting the incision site wet for a certain period.

People should speak with their doctor about any potential restrictions or guidelines to follow after their procedure. They may also need to attend a follow-up appointment within a month of the procedure.

Alternative treatment options for AFib include:

People can speak with their doctor to determine the best treatment option.

Cryoablation for AFib involves using extreme cold temperatures to create scar tissue in the heart. Doctors may suggest it as an alternative to radiofrequency ablation or when other treatments do not work.

People may need to avoid certain activities, such as driving, heavy lifting, or submerging the incision site in water, after cryoablation to treat AFib.

Deciding whether cryoablation is the right treatment for AFib involves a comprehensive evaluation by a healthcare team, considering the severity of AFib, symptoms, underlying heart conditions, and overall health.