BACKGROUND: Millions of Americans live with arrhythmias -- a disruption of the regular beating pattern of the heart. Atrial fibrillation, the most common arrhythmia, affects more than 2.2 million Americans today. Many patients experience the skipping or racing beats in conjunction with emotions or during exercise. Men are slightly more likely to develop atrial fibrillation than women, although women with the condition carry a higher risk of premature death. Older patients are more likely to have arrhythmias than younger ones. Other factors that affect risk are thyroid disorders, diabetes, high blood pressure, excessive alcohol consumption and cigarette or stimulant drug use (including caffeine). In most instances, arrhythmias exist in healthy hearts and patients can live with them with no negative consequences. However, they can be early indicators of more serious conditions that could lead to heart disease, stroke or sudden cardiac death. For these reasons, it is recommended patients experiencing symptoms of arrhythmia -- such as a "fluttering" feeling in your heart, racing heartbeat, shortness of breath, feeling tired or light-headed, and/or chest pain -- see their doctor.

TREATING ARRHYTHMIAS: When arrhythmias need to be treated, cardiologists first use anti-arrhythmic medications, such as digoxin or beta-blockers to try to regulate the heartbeat. If those methods fail, other surgical and non-surgical methods are considered. One commonly used method -- radiofrequency ablation -- is a minimally invasive outpatients procedure that uses heat to destroy defective signaling pathways to tame out-of-control nerve impulses. But a new technique known as cryoablation uses extreme cold -- as low as -90 degrees Celsius -- to destroy faulty tissues. The catheter device is inserted through a blood vessel in the groin, wrist or arm and then threaded to the heart. The ultra-low temperatures can destroy very small areas of faulty tissue without needlessly damaging the surrounding healthy tissue.

SUB-ZERO THERAPY: Cryoablation is performed in a two-step procedure, giving physicians an opportunity to assess the cooling effect on both normal and faulty tissues. First, the arrhythmia is mapped when the tissue is cooled from normal body temperature (37 degrees Celsius) to freezing (0 degrees Celsius). If doctors see a normal pathway stop conducting, the catheter can be thawed and the pathway will return to normal. If the cooling is found to only affect the arrhythmia, the catheter temperature can be further reduced to sub-zero temps to permanently eliminate the pathway.

This two-step procedure takes only minutes to complete. Doctors say it is a potentially safer way to correct arrhythmias in patients whose normal and diseased conduction pathways are close to each other, compared to radiofrequency ablation. Some doctors even say they use this new technique to treat 95 percent of their patients who need ablation for cardiac arrhythmias.

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Cedars-Sinai Medical Center
Patient Information Line: (800) 233-2771