The AF Treatment Revolution
Cryo-ablation has revolutionised the treatment of patients with atrial fibrillation. The procedure is quick (one hour), relatively painless and allows for short hospital stays. The incidence of post ablation cardiac arrhythmias, not uncommon with radio frequency ablation (RF), is exceedingly rare with cryoablation.
Take home message in 4 steps
1. Cryo-ablation is now the first line of treatment for a patient with AF
2. Refer patient with AF for cryo-ablation as early as possible for best outcomes
3. We follow a stepwise approach to minimise formation of scar tissue related to excessive ablation. Thus a patient with AF may need 2 – 3 ablation procedures.
4. Ablation in the hands of an experienced electrophysiologist is a safe and effective treatment modality.
Atrial fibrillation (AF) is a progressive condition that impacts more than 33 million people worldwide. Without early intervention, progression of the condition is associated with a higher rate of cardiovascular admissions, heart failure hospitalization, and mortality, along with a reduced quality of life.
Antiarrhythmic drug therapy (AAD) is currently the standard first-line treatment for patients with AF; however, AF recurs in approximately 50% of patients treated with AADs within a year of therapy onset.
In addition, AAD therapy frequently causes side effects that can lead many patients to discontinue treatment. Cryoablation uses cold energy (freezing) delivered through an inflatable balloon to create scar tissue to interrupt unwanted electrical pathways in the heart.
More than half of patients with symptomatic AF do not experience a reduction in AF with antiarrhythmic drugs, effectively delaying their therapy and leaving a critical need for an alternative first-line treatment.
The recently published STOP AF First findings show cryoablation is a potential first-line treatment for these patients, with the Cryo-FIRST study results showing encouraging benefits of this treatment approach on patients’ quality of life.