Balloon cryoablation for paroxysmal atrial fibrillation.

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Abstract
Catheter ablation has traditionally been performed for atrial fibrillation using a point-by-point ablation approach using radiofrequency energy. There are several inherent limitations of this approach. The efficacy of point-by-point radiofrequency ablation is limited by the rapid formation of oedema, which may potentially reduce lesion penetration, the relatively high incidence of conduction recovery and the inherent inaccuracies of trying to create curvilinear lesions using a technique that was originally developed and used for discrete point ablation. There are also inherent risks using radiofrequency energy in the relatively thin-walled left atrium including the risk of cardiac tamponade due to steam pop phenomenon as well as the risk of injury to adjacent structures including the pulmonary veins (stenosis), oesophagus, nerve plexi, aorta, bronchi, pericardium, phrenic nerve, and lungs. 1 Added to these problems is the observation that the procedure is extremely demanding in terms of operator competency and dexterity with a somewhat steep learning curve with better results seen in experienced higher volume centres. 1