Overview

What Is Radiofrequency Ablation?

Radiofrequency ablation is a nonsurgical procedure used to treat some types of rapid heart beating. It's most often used to treat supraventricular tachyarrhythmias. These are rapid, uncoordinated heartbeats. They start in the heart's upper chambers (atria) or middle region (AV node or the very beginning portion of the heart's electrical system).


What Are Some Common Uses Of The Procedure?

Radiofrequency ablation is used to treat early-stage lung cancer.

Radiofrequency Ablation Is A Viable And Effective Treatment Option If You:

Wish to avoid conventional surgery.

Are too ill to undergo surgery.

Have a small number of metastases in your lungs. These are tumors that have spread from a cancer located elsewhere in your body, such as the kidney, intestine or breast.

Have a large tumor that is too large to be removed surgically.


RFA Is Also Used To:

Reduce the size of a tumor so that it can be more easily eliminated by chemotherapy or radiation therapy.

Provide relief when a tumor invades the chest wall and causes pain.

RFA is not intended to replace surgery, radiation therapy or chemotherapy in all patients. It may be effective when used alone or in conjunction with these treatments.



How Is Radiofrequency Ablation Done?

A physician guides a catheter with an electrode at its tip to the area of heart muscle where there's an accessory (extra) pathway. The catheter is guided with real-time, moving X-rays (fluoroscopy) displayed on a video screen. The procedure helps the doctor place the catheter at the exact site inside the heart where cells give off the electrical signals that stimulate the abnormal heart rhythm. Then a mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the pathway. This destroys carefully selected heart muscle cells in a very small area (about 1/5 of an inch). That stops the area from conducting the extra impulses that caused the rapid heartbeats.



How Should I Prepare?

You should report to your doctor all medications that you are taking, including herbal supplements, and if you have any allergies, especially to local anesthetic medications, general anesthesia or to contrast materials (also known as "dye" or "x-ray dye"). Your physician may advise you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or a blood thinner for a specified period of time before your procedure.

Prior to your procedure, your blood may be tested to determine how well your liver and kidneys are functioning and whether your blood clots normally.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.

You may be instructed not to eat or drink anything after midnight before your procedure. Your doctor will tell you which medications you may take in the morning.

How Common Is This Procedure?

Radiofrequency ablation is widely used. It's the preferred treatment for many types of rapid heartbeats. It has a success rate of over 90 percent and a low risk of complications. Patients who have this done can resume normal activities in a few days. It causes little or no discomfort and is done under mild sedation with local anesthesia .


Catheter Ablation of Arrhythmias

Supraventricular Tachycardia



How Does The Procedure Work?

Radiofrequency ablation works by passing electrical currents in the range of radiofrequency waves between the needle electrode and the grounding pads placed on the patient's skin. These currents create heat around the electrode, which when directed into the tumor, heats and destroys the cancer cells. Because healthy liver tissue is better able to withstand heat, radiofrequency ablation is able to destroy a tumor and only a small rim of normal tissue around the edges of the tumor. At the same time, heat from radiofrequency energy closes small blood vessels and lessens the risk of bleeding. The dead tumor cells are gradually replaced by scar tissue that shrinks over time.

Ultrasound or computed tomography imaging may be used to help the physician guide the needle electrode into the tumor.

What Are The Benefits Vs. Risks?

Benefits

Radiofrequency ablation (RFA) is much less invasive than open surgery when treating primary or metastatic lung tumors. Side effects and complications are less frequent and less serious when RFA is carried out.

Patients who have multiple tumors or tumors in both lungs usually are not considered to be candidates for surgery. They may, however, be candidates for RFA.

Lung function is better preserved after RFA than after surgical removal of a tumor. This is especially important for those whose ability to breathe is impaired, such as current or former cigarette smokers.

When part of the tumor persists after RFA, radiation therapy may eliminate the remaining tumor cells. RFA very effectively destroys the central part of a tumor—the area that tends not to respond well to radiotherapy.

If a tumor recurs in the same region, it usually can be retreated by RFA. The procedure may be repeated multiple times if necessary.

Even when RFA does not remove all of a tumor, a reduction in the total amount of tumor may extend life for a significant time.

It takes much less time to recover from RFA than it does from conventional surgery.

RFA is a relatively quick procedure and recovery is rapid so that chemotherapy may be resumed almost immediately.

Radiofrequency ablation is less expensive than other treatment options.

No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed.



Risks

It is not uncommon for passage of the radiofrequency electrode to produce a condition called pneumothorax. This occurs when a collection of air or gas in the chest cavity collapses part of the lung. Usually no treatment is needed, but some patients may have a chest tube placed for up to a few days to drain the air.

Significant bleeding into the lung is an uncommon complication of radiofrequency ablation (RFA).

Fluid may collect in the space between the lung and its covering membrane. If the patient becomes short of breath, the fluid will have to be removed using a needle.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.

This procedure may involve exposure to x-rays. However, radiation risk is not a major concern when compared to the benefits of the procedure. See the Safety page for more information about radiation dose from interventional procedures.

Severe pain after RFA is uncommon, but may last a few days and require a narcotic to provide relief.

Though rare, an occasional patient with certain types of underlying lung disease may become worse after RFA, and in severe cases this may be fatal.

Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.

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