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At present, there is only one company (Medtronic) that manufactures a commercially available cryoballoon for pulmonary vein isolation. There are other competing technologies, but these do not use cold energy and instead rely on heat (radio-frequency), laser, or high frequency ultrasound. There is a new technology on the horizon called electroporation that uses electrical pulses for catheter ablation. This is not yet approved for wide spread clinical use. Radio-frequency ablation has been around for many years and it is still the main type used for catheter ablation for heart rhythm disturbances other than atrial fibrillation. The heat generated with this energy creates scar. The versatility is that it can deliver one tiny spot or can be used to “draw” a line or circle.

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