Risk Cryoablation against Microwaveablation.

[Guest guest]

I am male, 57 years old and have a few years AF. The last 6 months

more frequent. After knowing that I was on the list, my Atrial

fibrillation occurs less frequent. Before the message it was till 3

time/wk. Now it is less than one's per week. This with 200 mg/day

Tambocor CR.

At the moment I am on the wait-list to get Cryoablation in a hospital

at Amsterdam. The Cryo-ablation will be using the Maze approach on

the left Atrium This procedure has some risk (5% chance for trubble)

My question is: how are the risks with Microwave in comparison with

Cryo ablation.

Regards,

Nico Postma.

[Guest guest]

In a message dated 5/3/04 7:16:22 AM Eastern Daylight Time,

w.j.postma@... writes:

> My question is: how are the risks with Microwave in comparison with

> Cryo ablation.

>

>

Nico,

Good day. First, I think meant to say radio frequency and not microwave. I

don't know of anyone doing microwave ablations.

That being said, the choice between the two comes down to the industry

standard, radio frequency, and the latest, cryo. If I was to have another PVA ,

I

would go Cryo.

It eliminates the chances of stenosis of the pulmonary veins. There by

allowing the EP to work closer to the veins and surrounding areas.Success comes

down

to how well the EP maps and zaps the cells.

Using a maze platform to do this though is interesting. Is it the maze

catheter procedure or is the EP going in through the groin or neck?

Rich O

[Guest guest]

In a message dated 5/3/04 7:16:22 AM Eastern Daylight Time,

w.j.postma@... writes:

> My question is: how are the risks with Microwave in comparison with

> Cryo ablation.

>

>

Nico,

Good day. First, I think meant to say radio frequency and not microwave. I

don't know of anyone doing microwave ablations.

That being said, the choice between the two comes down to the industry

standard, radio frequency, and the latest, cryo. If I was to have another PVA ,

I

would go Cryo.

It eliminates the chances of stenosis of the pulmonary veins. There by

allowing the EP to work closer to the veins and surrounding areas.Success comes

down

to how well the EP maps and zaps the cells.

Using a maze platform to do this though is interesting. Is it the maze

catheter procedure or is the EP going in through the groin or neck?

Rich O

[Guest guest]

In a message dated 5/3/04 10:03:20 AM Eastern Daylight Time,

w.j.postma@... writes:

> Information on Microwave is from Cleveland hospital; see note and

> link.

>

Nico,

Thanks for the up-date on microwave technology at the CC. I've never heard it

discussed here or anywhere else. It's good to know.

Rich O

[Guest guest]

In a message dated 5/3/04 10:03:20 AM Eastern Daylight Time,

w.j.postma@... writes:

> Information on Microwave is from Cleveland hospital; see note and

> link.

>

Nico,

Thanks for the up-date on microwave technology at the CC. I've never heard it

discussed here or anywhere else. It's good to know.

Rich O

[Guest guest]

In a message dated 5/3/04 10:03:20 AM Eastern Daylight Time,

w.j.postma@... writes:

> Information on Microwave is from Cleveland hospital; see note and

> link.

>

Nico,

Thanks for the up-date on microwave technology at the CC. I've never heard it

discussed here or anywhere else. It's good to know.

Rich O

[Guest guest]

To Rich O

Thanks for your reacton.

Information on Microwave is from Cleveland hospital; see note and

link.

The Maze procedure will be via the catheter.

Apology for my short communication. This is because the English

language is not my native tongue my communication.

Regards,

Nico

http://www.clevelandclinic.org/heartcenter/pub/atrial_fibrillation/afi

b_innovations.htm

'Microwave technology uses a special catheter (the Flex-4 catheter)

to direct microwave energy to create several lesions on the heart.

The lesions block the conduction of abnormal electrical beats and

restore a normal heartbeat. The benefit of microwave radiation in

comparison to other surgical ablation techniques, is that the depth

and volume of heated tissue is more controlled and precise lesions

are created, and less charring of the heart's surface occurs,

decreasing the risk of blood clots that may travel to the brain or

other organs. Microwave energy cures atrial fibrillation in about 80

% of people.'

There is also a video

on 'http://www.clevelandclinic.org/heartcenter/pub/atrial_fibrillation

/afib_videos.htm'

> In a message dated 5/3/04 7:16:22 AM Eastern Daylight Time,

> w.j.postma@w... writes:

>

> > My question is: how are the risks with Microwave in comparison

with

> > Cryo ablation.

> >

> >

>

> Nico,

> Good day. First, I think meant to say radio frequency and not

microwave. I

> don't know of anyone doing microwave ablations.

> That being said, the choice between the two comes down to the

industry

> standard, radio frequency, and the latest, cryo. If I was to have

another PVA , I

> would go Cryo.

> It eliminates the chances of stenosis of the pulmonary veins. There

by

> allowing the EP to work closer to the veins and surrounding

areas.Success comes down

> to how well the EP maps and zaps the cells.

> Using a maze platform to do this though is interesting. Is it the

maze

> catheter procedure or is the EP going in through the groin or neck?

> Rich O

>

>

>

[Guest guest]

> In a message dated 5/3/04 7:16:22 AM Eastern Daylight Time,

> w.j.postma@... writes:

>

> > My question is: how are the risks with Microwave in comparison with

> > Cryo ablation.

> >

> >

>

> Nico,

> Good day. First, I think meant to say radio frequency and not microwave. I

> don't know of anyone doing microwave ablations.

> That being said, the choice between the two comes down to the industry

> standard, radio frequency, and the latest, cryo. If I was to have another PVA

, I

> would go Cryo.

> It eliminates the chances of stenosis of the pulmonary veins. There by

> allowing the EP to work closer to the veins and surrounding areas.Success

comes down

> to how well the EP maps and zaps the cells.

> Using a maze platform to do this though is interesting. Is it the maze

> catheter procedure or is the EP going in through the groin or neck?

> Rich O

Just a quick couple of points -

a quick search at pubmed will show that microwaves are being used

(though I suspect radio frequency is still the most popular method)

and here an interesting abstract comparing micro and radio ...

http://www.ctsnet.org/abstractsprogram/eacts/459?view=displayabstract & abstractid\

=18491

If my memory is working I vaguely remember reading few years ago that

one of the advantages for cryoablation was that they could test a site

before committing. They'd turn the temperature down low enough to

temporarily put cells out of action but not completely destroy them.

After doing some measuring they'd either turn the temperature down a bit

more to destroy the cells or let them thaw and recover if they missed

the spot. I'm not entirely sure how useful this is as far as nonspecific

isolation of the PVs goes or linear lesion lines for MAZE type ablation

- I suspect it's more of an advantage when targeting specific focal

points.

Reducing stenosis for PVI is an obvious plus point for cryo

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

2932615 & dopt=Abstract

I wonder if the " preservervation of underlying architecture " is the

reason for going the cryo route on the MAZE type ablation too?

as far as PVI ablation is concerned they appear to be experimenting with

tip modifications to isolate the veins quickly...

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abs\

tract & list_uids=15078415

--

D

[Guest guest]

> > In a message dated 5/3/04 7:16:22 AM Eastern Daylight Time,

> > w.j.postma@w... writes:

> >

> > > My question is: how are the risks with Microwave in comparison

with

> > > Cryo ablation.

> > >

> > >

> >

> > Nico,

> > Good day. First, I think meant to say radio frequency and not

microwave. I

> > don't know of anyone doing microwave ablations.

> > That being said, the choice between the two comes down to the

industry

> > standard, radio frequency, and the latest, cryo. If I was to have

another PVA , I

> > would go Cryo.

> > It eliminates the chances of stenosis of the pulmonary veins.

There by

> > allowing the EP to work closer to the veins and surrounding

areas.Success comes down

> > to how well the EP maps and zaps the cells.

> > Using a maze platform to do this though is interesting. Is it the

maze

> > catheter procedure or is the EP going in through the groin or

neck?

> > Rich O

>

> Just a quick couple of points -

> a quick search at pubmed will show that microwaves are being used

> (though I suspect radio frequency is still the most popular method)

> and here an interesting abstract comparing micro and radio ...

> http://www.ctsnet.org/abstractsprogram/eacts/459?

view=displayabstract & abstractid=18491

>

> If my memory is working I vaguely remember reading few years ago

that

> one of the advantages for cryoablation was that they could test a

site

> before committing. They'd turn the temperature down low enough to

> temporarily put cells out of action but not completely destroy them.

> After doing some measuring they'd either turn the temperature down

a bit

> more to destroy the cells or let them thaw and recover if they

missed

> the spot. I'm not entirely sure how useful this is as far as

nonspecific

> isolation of the PVs goes or linear lesion lines for MAZE type

ablation

> - I suspect it's more of an advantage when targeting specific focal

> points.

>

> Reducing stenosis for PVI is an obvious plus point for cryo

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12932615 & dopt=Abstract

> I wonder if the " preservervation of underlying architecture " is the

> reason for going the cryo route on the MAZE type ablation too?

>

> as far as PVI ablation is concerned they appear to be experimenting

with

> tip modifications to isolate the veins quickly...

> http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=15078415

>

> --

> D

Thanks verry much for the info. My AF is, after deciding to have a

cryoablation, much better. I am now convinced that by concentrating

less on the AF, I can postpone the ablation for a while. By postpone

some time the risks will reduce and I am able to make a better

choice.

Regards,

Nico