Cardiac ablation and mapping

Efficiency best practices

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Your trusted partner in lab efficiency

Predictability matters.

Predictability in AF ablation procedures can positively affect EP lab capacity. Medtronic cryoballoon's anatomical design efficiently contributes to this outcome.2

Ablation procedures performed with the anatomical design are more predictable when compared to contact-force radiofrequency procedures.2

Anatomical design

N: 570
Mean: 84.7 minutes
Standard deviation: 20.5
Frequency of > 1.5x median: 3.2%

Blue bar chart illustrating the predictability of ablation procedures performed with the anatomical design

Contact-force RF

N: 595
Mean: 171.3 minutes
Standard deviation: 48.2
Frequency of > 1.5x median: 8.9%

Blue bar chart illustrating the predictability of contact-force radiofrequency ablation procedures

Safe, effective, efficient procedures

Due to its safety and efficacy profile, and short procedural time, Medtronic cryoballoon ablation is the preferable option for AF ablation.3

Cryoballoon ablation is associated with a 21-minute shorter procedural time (p < 0.001) when compared with RF ablation.3

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Drive efficiency. Maximize capacity.

Medtronic cryoballoon ablation supports EP lab efficiencies transition from two to three PVI cases per day with focus on two operational areas4:

  • Overall lab occupancy time can be improved with shorter “skin-to-skin” procedure time, which can be influenced by catheter choice and associated learning curve for operator and staff.
  • Overall scheduling approach can be adjusted by extending the length of standard lab hours per day through split nursing shifts, efficient room turnover, and removing the restriction of case start times due to block scheduling.


increase in total cases over 1,000 days.4


of EP lab days without


of days with time for one additional non-ablation procedure.4

Restoring life’s rhythm. And the lab’s.

The Medtronic cryoballoon’s unique design enables additional protocols for consideration, including same-day discharge, fluoroscopy reduction, and moderate sedation. Learn more about the evidence and see it in action.

Same-day discharge (SDD)


Same-day discharge may be safe and feasible in select patients*5 and has potential to reduce healthcare costs.

Low rate of PVI-related complications and readmissions occurred in the SDD group:

  • 0.8% PVI-related complication rate
  • 3.6% Hospital readmission rate
Blue line chart representing hospital cost savings with the Medtronic cryoablation procedure

When 50% of every 100 patients had SDD, hospital cost savings ranged from $45,825 to $83,813 per year across geographically diverse U.S. hospitals.

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Watch a scientific exchange video.

Dr. Suneet Mittal and Dr. Rob Kowal share concepts and practices for same-day discharge for cryoablation procedures.

Log in to Medtronic Academy to view the video.

Fluoroscopy reduction


PVI using the Medtronic cryoballoon can be performed with low fluoroscopy and no radiopaque contrast agent.

Over 46 months, a progressive reduction in fluoroscopy time and radiation exposure to patients and staff was found, without an increase in complications and without compromising the goal of achieving complete PVI.6

Common practices and tools include:

  • Using 3D navigation and ICE
  • Pressure waveform monitoring and Doppler imaging
  • Using a cryoballoon dosing algorithm
  • When using fluoroscopy, minimize radiation exposure through slower fluoroscopy frame rate; collimator management, Y-axis gantry changes; and annual calibration of the fluoroscopy system
Two blue graphs representing reduction in radiation exposure when using fluoroscopy ablation procedures
Two blue graphs representing reduction in fluoroscopy time during ablation procedures
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View a scientific exchange video.

Dr. Devi Nair shares her experience with, and techniques for, minimizing fluoroscopy during cryoablation procedures.

Log in to Medtronic Academy to view the video.

Moderate sedation


Moderate sedation can be used with Medtronic cryoballoon7 which may benefit patient and hospital including:

  • Avoidance of risks associated with intubation and required additional monitoring
  • Faster patient recovery
  • Fewer challenges coordinating EPs and anesthesia for AF procedures
  • Lower hospital costs

When analgesics and/or sedatives are used, follow breathing management practices per treatment guidelines. At all times, it is the professional responsibility of the practitioner to exercise independent clinical judgment in a particular situation.

Blue bar chart representing sedation statistics when using the Medtronic cryoballoon
Video thumbnail

Watch a scientific exchange video now.

Dr. Rod Passman and Dr. Erik Wissner share their perspectives on moderate sedation with the cryoballoon.

Log in to Medtronic Academy to view the video.

More resources available on Medtronic Academy

Learn more about predictability, efficiency, and additional protocols and access peer-to-peer programs, manuals, and further education on Medtronic Academy.


Select patients without intraprocedural complications.



Colilla S, Crow A, Petkun W, Singer DE, Simon T, Liu X. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. October 15, 2013;112(8):1142–1147.


Monnickendam G, de Asmundis C. Why the distribution matters: Using discrete event simulation to demonstrate the impact of the distribution of procedure times on hospital operating room utilisation and average procedure cost. Oper Res Health Care. March 2018;16:20–28.


Fortuni F, Casula M, Sanzo A, et al. Meta-Analysis Comparing Cryoballoon Versus Radiofrequency as First Ablation Procedure for Atrial Fibrillation. Am J Cardiol. 2020;125(8):1170–1179.


Kowalski M, Su WW, Holbrook R, Sale A, Braegelmann KM, Calkins H; STOP Persistent Investigators. Impact of Cryoballoon Ablation on Electrophysiology Lab Efficiency During the Treatment of Patients With Persistent Atrial Fibrillation: A Subanalysis of the STOP Persistent AF Study. J Invasive Cardiol. 2021;33(7):E522–E530.


Sahashi Y, Kawamura I, Aikawa T, et al. Safety and feasibility of same-day discharge in patients receiving pulmonary vein isolation-systematic review and a meta-analysis. J Interv Card Electrophysiol. 2022;63(2):251–258.


Reiss J, O'Connell H, Getman MK. Achieving contrast-free ultra-low radiation exposure without compromising safety and acute efficacy through evolving AF cryoballoon ablation procedure techniques. Int J Cardiol. 2020;299:153–159.


Wasserlauf J, Knight BP, Li Z, et al. Moderate Sedation Reduces Lab Time Compared to General Anesthesia during Cryoballoon Ablation for AF Without Compromising Safety or Long-Term Efficacy. Pacing Clin Electrophysiol. 2016;39(12):1359–1365.