A catheter has a cooling distal section for freezing tissue to sub-zero temperatures with one or more miniature reverse thermoelectric or Peltier elements, also referred to herein as micro-Peltier cooling (MPC) units or electrodes. The MPC units may be on outer surface of an inflatable or balloon member or a tip electrode shell wall that has a fluid-containing interior cavity acting as a heat sink. Each MPC unit has a hot junction and a cold junction whose temperatures are regulated by the heat sink, and a voltage/current applied to the MPC units. A temperature differential of about 70 degrees Celsius may be achieved between the hot and cold junctions for extreme cooling, especially where the MPC units include semiconductor materials with high Peltier co-efficients. An outer coating of thermally-conductive but electrically-insulative material seals the MPC units to prevent unintended current paths through the MPC units.
