This procedure provides a new option for some patients living with Atrial Fibrillation, the most common heart rhythm problem affecting adults in America. Currently, more than 4 million people carry the diagnosis of Atrial Fibrillation with many more yet to be diagnosed. There is an increasing incidence with age, and it is estimated that 25% of adults over 40 will develop Atrial Fibrillation during their lifetime. Atrial Fibrillation can result in a dramatic reduction in quality of life, physical condition, mental health and social functioning, as well as cause congestive heart failure, stroke, dementia, and death. Fortunately, successful ablation of Atrial Fibrillation has proved in multiple research trials to normalize the above quality of life measures and reduce the incidence of congestive heart failure, stroke, dementia, and death.
Ablation of Atrial Fibrillation is based on the groundbreaking work published in 1998 by Dr. Michel Haissaguerre. In his publication, Dr. Haissaguerre described that 94% of the triggers of Atrial Fibrillation are located in the pulmonary veins. When the muscle within these veins is exposed to the stress of hypertension, increased age, obstructive sleep apnea, obesity, and certain adrenergic and hormonal changes, the result is rapid electrical activity and Atrial Fibrillation. The electrical isolation of these veins from within the heart is the cornerstone of Atrial Fibrillation ablation therapy. Since Dr. Haissaguerre’s findings, more than 7000 patients undergoing ablation in research trials prompted the Heart Rhythm Society, in conjunction with the American College of Cardiology the American Heart Association to recommend ablation as a class 1 recommendation for the first line of treatment for many patients with Atrial Fibrillation.
While initial ablation procedures involved the delivery of a radiofrequency “burn” lesion at a single point, today’s cryoballoon ablation delivers a continuous circular lesion around the ostium of the vein with a single application of cryoablation. This simplified approach to pulmonary vein isolation results in a significant reduction in procedure duration and X-ray radiation exposure to the patient and physician. Another advantage of the cryoablation technology is that cryoballoon freezes and sticks to the beating heart, delivering ablation energy to the desired area throughout cardiac contraction.
The Medtronic Arctic Front Advance™ cryoablation system. Image reproduced with permission of Medtronic.
Since introducing this procedure at Oklahoma Heart Institute, patient results have been remarkable, with an acute procedural success rate of 100%. During short-term follow-up, success rates for paroxysmal Atrial Fibrillation are currently over 90%. As expected, procedure duration and X-ray exposure times continue to improve and are superior to the previous point to point radiofrequency ablation technology.
A Patient's Story