Radiofrequency ablation

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Radiofrequency ablation (RFA) is use of radiofrequecy energy to destroy biological tissue for medical treatment.

[edit] Use in Cardiology

Radiofrequency energy is used to destroy abnormal electrical pathways in heart tissue. It is used in recurrent atrial fibrillation and other types of supraventricular tachycardia. The energy emitting probe (electrode) is placed into the heart through a catheter. The practitioner first "maps" an area of the heart to locate the abnormal electrical activity before the responsible tissue is eliminated. Ablation is a newer technique and has shown some promise for cases unresponsive to conventional treatments. New techniques include the use of cryoablation (tissue freezing using a coolant which flows through the catheter), and microwave ablation, where tissue is ablated by the microwave energy "cooking" the adjacent tissue. The abnormal electrophysiology can also be modified in a similar way surgically, and this procedure referred to as the "Cox maze procedure", is commonly performed concomitantly with cardiac surgery.

This procedure is usually performed by a subspecialty of cardiologists known as cardiac electrophysiologists.

[edit] Other uses

Applications other than cardiology field include ablations of tumor masses, e.g. hepatocellular carcinoma, adrenal tumors and breast tumors. Usually, under ultrasonographical guidance, a radiofrequency probe is inserted into the tumor mass. By exerting radio-energy with frequency around 460 kHz, the tumor mass is heated and destructed. Coagulation necrosis can be shown microscopically. The most extensively investigated field should be the treatment of hepatocellular carcinoma in gastroenterology. According to the Barcelona Consensus 2002, such technique had been ranked " curative " procedure and proved as effective as surgical resection and chemical injection provided the hepatic tumor mass is smaller than 3 cm and the total tumor number fewer than 3.

RFA is also used in radiofrequency lesioning, somnoplasty, and for vein closure in areas where intrusive surgery is contraindicated by trauma.

Radiofrequency ablation is also used to treat inoperable tumors in the liver and other organs. Energy is applied to the tumor mass through a needle to heat the tissue to a temperature that will result in cell necrosis. Radiofrequency energy is also used in liver resection to control bleeding (hemostasis) and facilitate the transection process.