Freezing, Burning, Both Work in AFib

Treating atrial fibrillation by ablation is equally effective whether done by freezing or burning small parts of the heart.

Treating atrial fibrillation (AF) can mean procedures focused on deadening areas of the heart to shut down erratic electrical signals and bring the heart back to a normal state.

In a trial called FIRE AND ICE researchers in Germany found that either freezing the targeted area or heating it with radio waves, the traditional approach, are equally effective.

"The trial demonstrated that the cryoballoon, a newer easier to use ablation catheter worked as well as the established technology," said Karl-Heinz Kuck, MD, PhD, of St. George Hospital in Hamburg.

The study was reported today at the American College of Cardiology's 65th Scientific Session & Expo in Chicago, IL.

AF affects more than 33 million people worldwide and can cause fatigue, lightheadedness, shortness of breath, chest pain and an increased risk of stroke.

About 30% of AF patients do not benefit from drugs for the condition.

In the trial, 769 patients in eight countries in Europe were randomized to get either treatment. The results were similarly effective with a low rate of procedure-related complications.

But patients receiving cryoballoon ablation had a higher chance of injury to the phrenic nerve while none of the radiofrequency ablation had such a mishap. The nerve injury resolved in all but one patient.

Cryoablation was quicker, taking about 18 minutes less per procedure.

That speed also made it more cost-effective, Kuck noted.

The study was funded by Medtronic and was published online today in The New England Journal of Medicine.