Vol. XIX, No. 4, Fall 2011
Dr. David Penfield, an Emergency Room physician at Cape Cod Hospital, is back riding his bike...20-30 miles at a fast pace with no problems...and he’s gradually tapering off his heart medications.
All because a colleague, Dr. Peter Friedman, an electrophysiologist, made a trip to Minnesota this past May…and it wasn’t for the fishing.
Dr. Friedman’s journey was to train at the corporate headquarters of Medtronic, developer of the new cryoablation technique for treating atrial fibrillation, the most common form of heart arrhythmia.
This new procedure is known as Balloon Cryoablation for Paroxsymal Atrial Fibrillation (AF) and since his trip Dr. Friedman has done nearly 20 successful procedures, including Dr. Penfield’s in August.
During AF, the heart’s two upper chambers, the atria, quiver instead of contract. Sufferers may have heart palpitations, shortness of breath and weakness and fatigue.
Dr. Penfield had tried medication to control his condition, but to no avail. So, when he learned of the new procedure, which is shorter in duration and has fewer risks, he decided to see if this would do the trick.
Balloon Cryoablation disables the cells in the heart that create the irregular heartbeat by freezing them. During the minimally invasive procedure, a thin flexible tube, called a balloon catheter, locates and freezes the tissue that triggers the AF. The balloon is inflated, cutting off the blood supply for several seconds while the tissue is frozen.
Prior to the Balloon Cryoablation, Dr. Friedman treated AF using Radiofrequency Ablation, which involves burning the cells. But this can create scarring which can close off the vein or create blood clots that can cause a stroke. Still another, life-threatening, complication can emerge with Radiofrequency Ablation. Because the wall of the left atrium, or chamber, of the heart is very thin, a fistula or opening can occur leading into the esophagus.
While Balloon Cryoablation is not without risk, Dr. Friedman says there is a greatly reduced chance of blockage from scar tissue and stroke. The new procedure also cuts down on time and complications and usually takes only about three hours, compared to four or five.
Ideal candidates for the new procedure have no underlying structural heart disease, feel poorly when they are in AF and have not had luck controlling the condition with medication. It works best for people with intermittent AF, but may also be considered for patients with constant arrhythmia.
It usually takes several months for the heart to heal after the procedure, but Dr. Penfield said he noticed some difference immediately. He had a single episode of AF while riding his bike five days after the procedure, but now he’s cycling full speed ahead.