Treatments & Therapies

Radio Frequency Ablation – Treatment, Effect & Risks

Radiofrequency ablation

High – frequency ablation is a medical procedure in which defined tissue areas are destroyed by high-frequency currents caused by heat.

The procedures are mainly used to destroy metastases in the liver and to treat atrial fibrillation . High-frequency ablation can be performed minimally invasively using a catheter and is therefore particularly gentle. It can be repeated if necessary in the event of recurring problems.

What is Radio Frequency Ablation?

High- frequency ablation is also synonymously referred to as radio frequency or thermal ablation . Electrodes are placed in the immediate vicinity of the tissue to be destroyed by an applicator or catheter and heated by a high-frequency current of around 460 to 480 kilohertz.

Despite different, competing systems, the power consumption at the electrodes is mostly around 200 watts. The effects of heat result in relatively sharply demarcated areas of destroyed tissue (heat necrosis), which can be further broken down by the body’s own metabolism and, in the case of sclerotherapy in one of the atria, loses its electrical conductivity and electrical initiation potential. Radiofrequency ablation is usually performed using minimally invasive techniques.

This offers the advantage of repeatability in the event of unsatisfactory results or recurring problems. When fighting metastases in the liver , significantly less valuable functional liver tissue is removed than in conventional surgical interventions.

Function, effect & goals

High-frequency ablation is mainly used in two completely different areas of application. On the one hand, there are oncological applications, which mainly serve to combat metastases, and on the other hand, a cardiological treatment method for so-called atrial fibrillation.

In cancer medicine , thermal ablation is used less to destroy a primary tumor than to necrotize metastases if the primary tumor belongs to the class of tumors that can metastasize. There is extensive experience with the destruction of metastases in the liver and in the vertebral bodies – mostly as an adjunctive therapy to chemotherapy and radiotherapy . However, there are no scientific studies that could prove any advantages of radiofrequency ablation over open surgical interventions.

Basically, it is assumed that the main advantage of the minimally invasive destruction of metastases settled in the liver by thermal ablation causes less damage to the intact liver tissue than open surgical interventions. The surgical procedures inevitably remove more functionally healthy liver tissue than is the case with radiofrequency ablation. The goal of ablation in oncology is to prevent the metastases from growing further and to cause them to die. When using high-frequency ablation in cardiologyIt is less about the destruction of tissue and more about permanently changing the electrophysiological properties of certain cardiac muscle cells in such a way that they cannot transmit or generate any electrical stimuli for the contraction of the atria.

Atrial fibrillation, which is observed relatively frequently in older people, is usually caused by the fact that heart muscle cells in the left atrium near the confluence of the pulmonary veins transmit uncoordinated electrical signals emanating from the pulmonary veins and cause the atria to arrhythmically and very quickly contract. They ignore the electrical impulses sent out by the sinus node, the main clock generator in the right atrium. The goal of radiofrequency ablation to control atrial fibrillation is to render the myocardial tissue around the pulmonary vein junctions electrically inactive.

This roughly corresponds to electrical isolation of the openings of the pulmonary veins in the left atrium (pulmonary vein isolation). While the goal of thermal ablation in oncology is the destruction of diseased tissue (metastases), the goal of high-frequency ablation for the treatment of atrial fibrillation is the sustained electrophysiological change in fundamentally healthy heart muscle cells. The particular advantage of minimally invasive thermal ablation compared to surgical intervention lies in the repeatability of the ablation if the result is unsatisfactory or if recurrences form.

The high-frequency ablation for atrial fibrillation is opposed to the so-called cryoablation , in which the ablation is not achieved by the effects of heat but by the effects of cold. The main advantage of cryoablation over thermal ablation is that during cryoablation, the affected tissue can be pre-cooled. The electrophysiological effects can then be measured and checked. If the expected effect does not occur, the intervention can be canceled and the tissue is fully functional again after the temperature has adjusted.

Risks, side effects & dangers

The direct risks associated with minimally invasive radiofrequency ablation to combat metastases are estimated to be very low. They are below those of a conventional surgical procedure. The greatest “danger” is that the desired goals are not achieved with the first treatment or that recurrences appear.

In most cases, the thermal ablation can then be repeated without any problems. The treatment of atrial fibrillation by radiofrequency ablation, for example in the left atrium, can also be considered to be low-risk. However, there are higher technical risks because, for example, a planned electrical isolation of the pulmonary veins requires a catheter to be advanced through a groin vein into the right atrium and then to pierce the septum between the two atria in order to enter the left atrium into the to reach the confluences of the four pulmonary veins.

The main risks with this treatment are not so much in performing the ablation as in maneuvering the cardiac catheter to the site of use in the left atrium. Possible complications can arise from the formation of blood clots , which can cause thrombotic events, as well as from injury to the pericardial sac or esophagus . Severe bleeding can also occur where the cardiac catheter enters the groin vein . The above risks of injury are minimized when the procedure is performed by an experienced doctor.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.