Talk:Radiofrequency ablation

I just borrowed some text from atrial fibrillation to start this stub. As I have more time I will add to it.

RF vs. AC or DC

I hesitate to delete references to RF "current" as opposed to low-frequency AC or DC current, because I'm not certain they're totally wrong. But RF is "waves," aka electromagnetic energy (the same spectrum as visible light, UV and infrared), and not electricity or current of any sort. Maybe the author is referring to the fact that the RF is generated electrically, even though no electricity is delivered to the patient; conceivably, that's somehow relevant here. But the fact that AC electric current also has "frequency" (e.g., US house current is 60 cycles per second) is irrelevant to "radiofrequency" energy. Anyhow, I hope someone who's certain will change "current" to "waves" and not worry about the frequency of the radio waves (presumably, many kilohertz or megahertz, but irrelevant to elecricity). — Preceding unsigned comment added by 71.249.196.188 (talk) 20:52, 27 March 2012 (UTC)

Groins

I removed the following sentence since it did not make sense to me. Catheters are often inserted through the groins and neck pain usally lasts from 1-6 weeks after. It is true that RFA is usually performed through introducers inserted in the groin (femoral vein usually) or sometimes the internal jugular, Neither usually causes neck pain. And as far as my medical knowledge extends, most people only have one groin. --John^DO|^{Speak your mind} 05:20, 22 April 2006 (UTC)

I had the procedure done and I guess the neck pain will result from having to lie flat for 4-6 hours with the head flat on the pillow immediately after the procedure, but of course that's not direct.--Exander 03:47, 2 September 2006 (UTC)

I'm a medical malpractice litigator who has become familiar with interventional radiology and interventional cardiology, most of which is done via a catheter entering a blood vessel at the groin (where big femoral arteries and veins are right near the skin). They place contrast material for radiology images of the blood vessels, or inflate balloons or place stents in narrowed arteries. But radiofrequency ablation does not necessarily involve threading a catheter through the body at all; a cardiologist would only do it to ablate nerves controlling heart rhythm (as in AF). Ablation of tumors in organs could go through an oral-gastric endoscope (e.g. to reach gallbladder or pancreas ducts), and not blood vessels at all. The "pain management" section of the article ablates sensory nerves instead, usually nerve roots about the spine, which wouldn't use any type of catheter or scope. Rather, a slender rigid needle/probe sticks through the skin directly into a site at the nerve root. That could be in the neck, but in any event I don't see how a groin is ever relevant to RFA for tumors or nerves. Plus, the original text was nonsense anyway. An internal jugular is at the opposite end of the torso from the groin. And RFA is not the cause of neck pain - rather, it's a treatment (wherever along the spine pain is caused, neck or elsewhere), albeit a treatment giving full relief only in 1-6 weeks).

RFA FREQUENCY and ADVERSE RESULTS

Q, how often can RFA be performed and does it leave any lasting adverse effects?

I had RFA performed more than a year ago and it provided significant pain relief for 4-5 weeks. Because it was the only procedure that has provided relief I wish to have it again. My pain management doctor has agreed to perform the procedure again but says it can only be done once every six months. Q, is the once every six months for medical reasons or insurance (Medicare and an AARP supplement) reasons?

Also, are there any adverse effects from RFA like additional scarring or anything else.

Thank you in advance for any light which can be shed on my Qs, particularly the frequency issue. Benzman1 (talk) 19:21, 12 February 2011 (UTC)

"Radiofrequency" or "Radial Frequency"?

Going by Google, "radiofrequency" is by far more common. However, I have seen multiple doctors write it as "radial frequency". Any true experts that can clear this up?

-- "Radial frequency" is nonsense. I'm a medical malpractice litigator who has usually found, upon questioning at depositions, that errors like that in what doctors "write" are due to transcriptionist error. In this case, they'd think they hear "radial" because it's more common in medicine than "radio," so they'd write it wrong. — Preceding unsigned comment added by 71.249.196.188 (talk) 20:20, 27 March 2012 (UTC)

Radiation?

I saw an article concerning RFA for Barrett's Esophagus, and one thing it mentions as a counter-indication is if the patient has previously had radiation treatment. Does that then mean that this is also a form of radiation treatment, and if so what sort of risks exist? — Preceding unsigned comment added by 12.45.169.2 (talk) 17:30, 18 February 2013 (UTC)

Radiation? As a practising electrophysiologist I should explain that ablation means no more or less that locallised tissue injury. Radiofrequency current (not radiation) causes heating of the tissues adjacent to the tip of the catheter and thus burning injury with subsequent scarring over an area of 2-3 mm diameter. A similar effect can be created by extreme cold - cryoablation - causing freezing injury with possibly less scarring. In treating heart arrhythmias the aim is to damage heart muscle fibre connections (not nerves) which are causing or permitting the arrhythmia. There is no possibility of radiation damage, except from the prolonged use of X-rays to position the catheter - this is nowadays kept to a minimum.

RF vs. AC or DC? Radiofrequency current, rather than lower frequency AC or even DC, is used as it does not stimulate nerves and therefore does not give the sensation of an electric shock. The very first catheter ablations in the 80s did use DC shocke and required a general anaesthetic.

Groins? in medical terms there are 2 groins, right and left. Access to the heart is usually via the femoral vein which leads to the right side of the heart. Access to the left side is either direct via the femoral artery or via the vein by making a hole between the right and left atria (trans-septal technique).

Outside of cardiology, RFA is used to destroy nerves, cauterise abnormal tissue, make holes and other things, with minimal "invasion". DrJCPC (talk) 21:39, 18 February 2013 (UTC)

So, why is prior radiation treatment to the esophagus a contraindication for the use of RFA to destroy Barrett's esophagus?

I'm not an expert in this (you need a gastroenterologist) but I would guess that prior radiation - to treat cancer - would cause scarring and possibly thinning of the oesophagus wall and increase the risk that RFA could perforate the oesophagus which would be a very serious complication.DrJCPC (talk) 13:50, 23 February 2013 (UTC)