Radio Frequency blation – How Does it Work?
Radiofrequency is a type of electrical energy that has been used in medical procedures for decades. At the most basic level, this electrical energy is used to create heat. The heat is created in a specific location, at a specific temperature, for a specific period of time, and ultimately results in the death of unwanted tissue.
During a radiofrequency procedure, an ablation probe is placed directly into the target tissue. An array of several small, curved electrodes are deployed from the end of the probe into the tissue. The generator is turned on and target temperatures are input. The radiofrequency energy flows through the electrodes, causing ionic agitation, and therefore friction, in the nearby tissue. This friction creates heat, and once sufficient temperatures have been reached, the heat kills the target tissue within a few minutes. Thermocouples (tiny thermometers) incorporated into the tips of the electrodes allow continuous monitoring of tissue temperatures, and power is automatically adjusted so that the target temperatures remain constant.
CT guidance/ Ultrasound is typically used to monitor the treatment process. Heat is a very effective means of killing tissue. As tissue temperature rises above 113° F (50° C), protein is permanently damaged and cell membranes fuse. The process is rapid, typically requiring less than 10-15 minutes exposure time for a 5cm ablation. Depending on the power applied and the resistance of the tissues, heat decreases rapidly at a specific distance from the electrode tip, limiting the ablation size. The size of the ablated area is determined largely by the size of the probe, the temperature of the tissue, and the duration of time the energy is applied. There is a sharp boundary between dead tissue and unaffected surrounding tissue. Thus unwanted tissue can be ablated without much sacrifice of surrounding normal tissue.
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What is an RF procedure like?
One option is a percutaneous approach, in which the electrode is inserted through the skin to the desired location. The radiologist usually uses ultrasound or CT guidance to guide the needle to the right location.
This is the least invasive way that RF is performed. General anesthesia is usually not necessary, but typically the patient is sedated. If general anesthesia is not used, some discomfort or pain maybe felt while the area is being ablated. Patients may experience a slight fever for two or three days after the procedure. Physicians often allow the fever to resolve without intervention. RF ablation procedures have a relatively low rate of complications. Most of the complications are considered minor. The following are the complications associated with this procedure: infection (abscess), bleeding, pnuemothorax, abnormal heart rhythms, and skin burn.
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