Cold Ablation (Cryoablation)

Cold Ablation Ankara (Cryoablation)

Today, one of the most effective treatment methods used in the treatment of heart rhythm disorders is ablation. Unlike medical drugs, ablation is a method that provides a permanent and more effective treatment (for more detailed information, see section what is ablation?). For this reason, the ablation procedure helps many patients with arrhythmia to relax for life or for many years. There are currently two different types of energy used during ablation. These are the combustion process using radio waves and the cooling or freezing processes using nitrogen gas. Therefore, there are two different ablation methods according to the energy source used. For this reason, the first of these is called “warm ablation” and the second is called “cold ablation”. Cold ablation is called “Cryoablation” in medical language. It has different advantages and disadvantages. Depending on the type and severity of palpitation, ablation can be applied by burning or freezing and the factor causing cardiac arrhythmia can be completely eliminated. In this article, we will discuss “cold ablation”, one of the ablation methods. If you want to consult about other methods used in the diagnosis and treatment of heart diseases, you can contact clinic of Prof. Basri Amasyalı in Ankara.

What is Ablation?

To fully understand what cold ablation is, first of all, “What is Ablation?” Let’s take the question. Ablation is an interventional treatment for the elimination of heart rhythm disorders. The purpose of ablation method; It is the elimination of electrical problems that cause heart rhythm disorders by burning or freezing. The meaning of the word ablation is to remove or destroy something. It is a permanent or more effective treatment option than drug treatment. Today, ablation has become one of the first-choice methods in the treatment of cardiac arrhythmias, as it eliminates the need for lifelong drug use. “Warm ablation” to the ablation process by burning; what is done by freezing is called “cold ablation”. For more detailed information about ablation, you can find detailed information in “what is ablation?” section.

What is Cold Ablation?

In the cold ablation process, the target area is exposed to cold between -50 and -70 degrees. Another name is the ablation process with the “freezing method”. Warm and cold ablation has its own advantages and disadvantages. The important point here is to correct diagnosis of the factor causing arrhythmia. According to the type and severity of palpitation, the final evaluation is made in the light of the patient’s data and one of the cold or warm ablation methods is decided.

To Whom Cold Ablation Can Be Performed?

Ablation is a procedure that can be done to anyone, regardless of age and gender. It is an ideal treatment to provide an effective and permanent solution, especially in patients with severe heart arrhythmia. Cold ablation does not address a specific group of patients. It can be applied to patients of all ages. First of all, the patient’s underlying rhythm disorder should be clearly revealed. We prefer cold ablation relatively more in the younger age group of patients with some special rhythm disorders. The first of these is the situation where the focus causing heart rhythm disorder is close to the main cable of the heart. Cold ablation can be preferred in some special cases of diseases that we define as “AVNRT” and “WPW syndrome” in medical language and in some “atrial tachycardias”. Cold ablation can also be preferred for “atrial fibrillation” ablations, which have been increasingly used in recent years.

What are the Advantages of Cold Ablation Treatment?

The biggest advantage of cold ablation over warm ablation is that it allows us to be more controlled at the ablation point. This means this: As I mentioned above, the point where some rhythm disorders occur can be very close to the main electrical system of the heart. In such cases, we risk damaging the heart’s own electrical system, albeit unintentionally, while ablating. When such a risk occurs, it is difficult to put a “pacemaker” on the patient. Some patients say, “I was going to have ablation, but I gave up on ablation because there was a risk of battery insertion”. In fact, in some of these patients, the focus that causes rhythm disturbances can actually be close to the main electrical system of the heart. Warm ablation poses a risk of pacemaker between 0.1% and 1% in such patients. In addition to the factors related to the patient, the experience of the physician performing the procedure is also extremely important for the risk range to be so wide. In such special cases, we can prefer cold ablation instead of warm ablation. In cold ablation, the desired point is cooled gradually and in case of any negativity, the cooling process can be stopped abruptly and the surrounding tissue can be protected. If it is done in experienced centers, the risk of battery is almost non-existent in cold ablation.

What are the Disadvantages of Cryoablation Treatment?

Of course, every advantage has its disadvantage. The major disadvantage of cold ablation or “cryoablation” is that it can relapse more often than incineration. In other words, the point that we destroy with ablation can be revived months or even years later, and the rhythm disorder can start again in the person. But in such a case, there is no need to worry. I call them our lucky patient group. Because the risk of regeneration of the focus is around 5% and in such cases, the process is repeated.

Which Diseases Is Cold Ablation Used To Treat?

Many types of arrhythmias can be treated with Cryoablation treatment. The most common types of palpitations that Cold Ablation treatment is used for are as follows:

  • Atrial fibrillation
  • Wolff – Parkinson – White syndrome: those with the problem area very close to the heart’s mains lead (see Supraventricular tachycardias).
  • Atrial tachycardia: in those where the problem area is too close to the heart’s mains lead (see Supraventricular tachycardias).
  • AVNRT : those where the problem area is very close to the main electrical cable of the heart (see Supraventricular tachycardias).

How to Perform Cold Ablation?

Cold ablation method is the same as our general ablation approach in the second phase of the EPS, the “electrophysiological study”. The only difference from warm ablation is the use of a different ablation system. The ablation catheter and the energy source to which it is connected are completely different. However, it has the same principle and discipline as warm ablation in terms of the way it is done. The target area or point in the heart is reached with the cold ablation catheter. With the help of catheters, cold application can be made to the target area. By means of the cold application, which is between -50 and -70 degrees, the problematic areas or points in the heart are eliminated.

Cold ablation is performed by giving light sleep to the patient, which we call “sedation” according to the type of rhythm disorder to be ablated, just like in warm ablation. As in warm ablation, the veins in the groin area are often used in cryoablation. If the patient is very uneasy about the procedure or if the procedure will take too long, general anesthesia can also be preferred. Patients are usually discharged 24 hours after the procedure. Patients can often return to their daily lives on the date of discharge.

(A specially manufactured catheter is used during cryoablation for Atrial Fibrillation ablation. There is a 28 mm diameter balloon at the tip of this catheter and the “freezing” process is done by this balloon. This balloon provides cooling in the target area of the heart at -50 to -70 degrees. In cryoablation applied in rhythm disorders other than Atrial Fibrillation, the same catheters are used visually as other ablation catheters and they are in the form of a cable with a thickness of 1-2 mm.)

Ankara Cold Ablation Treatment

The role of the experienced team is great in cold ablation treatment. Before the treatment is planned, the underlying causes of the rhythm disorder must be clarified. If the cause of the arrhythmia is unknown, a definitive diagnosis should be made by performing EPS. Cryoablation can be performed on any patient. There is no age limit. However, which type of ablation will be performed should be decided after a detailed examination. There are some rhythm disorders that cold ablation is an advantage. But there are some rhythm disorders that cold ablation cannot provide any benefit. If you want to get detailed information about cold ablation treatment and prices in Ankara, you can contact clinic of Prof. Basri Amasyalı.

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