Journal of Hospital & Medical Management

Description

Radiofrequency Ablation (RFA), also known as fulguration, is a medical procedure in which heat generated by medium frequency alternating current (350–500 kHz) is used to ablate a portion of the electrical conduction system of the heart, a Tumour, or other dysfunctional tissue. Most of the time, RFA is done in an outpatient setting, and either local anesthetics or conscious sedation anesthesia is used. It is known as radiofrequency catheter ablation when it is administered through a catheter.

Compared to low-frequency AC or DC pulses, radio frequency current has two significant advantages: It does not directly stimulate nerves or heart muscle, so it can often be used without general anesthesia and it is very specific for treating the desired tissue without causing a lot of collateral damage. Because of this, it is acquiring in ubiquity as an option for qualified patients who would rather not go through a medical procedure. RFA procedures are carried out by an interventional pain specialist (such as an anesthesiologist), an interventional radiologist, an otolaryngologist, a gastrointestinal or surgical endoscopist, or a cardiac electrophysiologist, a subspecialty of cardiologists, under image guidance (such as X-ray screening, CT scan, or ultrasound).

Atrial Fibrillation

The treatment of Tumours in the bone, the liver, the kidney, the lung and other less common body organs can all benefit from RFA. A RFA probe resembling a needle is inserted within the Tumour once the diagnosis of the Tumour is confirmed. The temperature of the Tumour tissue rises as a result of the probe's radiofrequency waves, which destroy the Tumour. Small Tumours, whether primary Tumours that originated within the organ or metastases that spread to the organ, can be treated with RFA. RFA's suitability for a particular Tumour depends on a number of factors. RFA can typically be given out of the hospital, though it may at times need to be done out of the hospital for a short time. Hepatocellular carcinoma, also known as primary liver cancer, can be treated with RFA in conjunction with locally administered chemotherapy. As a treatment for Hepatocellular Carcinoma (HCC), a method that uses the low-level heat (hyperthermia) generated by the RFA probe to trigger the release of concentrated chemotherapeutic drugs from heat-sensitive liposomes in the margins around the ablated tissue is currently in phase III trials. Radiofrequency ablation is also used to treat pancreatic cancer and bile duct cancer. RFA has become increasingly important in the treatment of benign. While initial success rates with RFA are high, symptom recurrence after RFA treatment has been reported, with some studies demonstrating a recurrence rate similar to that of surgical treatment. RFA is also increasingly used in the palliative treatment of painful metastatic bone disease in people who are not eligible or do not respond to traditional therapies (i.e. radiation therapy, chemotherapy, palliative surgery, bisphosphonates, or analgesic medications).

In normal heart tissue or parts, radiofrequency energy is used to destroy abnormal electrical pathways that cause a cardiac arrhythmia. Recurrent Atrial Flutter (RAF), Atrial Fibrillation (AF), Supraventricular Tachycardia (SVT), Multifocal Atrial Tachycardia (MAT) and some ventricular arrhythmias all benefit from its application. The tip of a catheter, which is typically inserted into the heart through a vein, contains the energy-emitting probe (electrode). The ablator is the name of this catheter. Before removing the responsible tissue, the physician first "maps" a portion of the heart to locate the abnormal electrical activity (electrophysiology study). Ablation is now the standard treatment for SVT and typical atrial flutter and it can also be used to block conduction in the left atrium, especially around the pulmonary veins, after implantation of a pacemaker or to block the atrioventricular node in AF. Cryoablation (tissue freezing using a coolant that flows through the catheter) can be used to perform ablation in some conditions, particularly forms of intra-nodal re-entry, also known as atrioventricular nodal reentrant tachycardia or AVNRT, which is the most common type of SVT. Cryoablation eliminates the risk of complete heart block, which is a potential complication of radiofrequency ablation in this condition; However, cryoablation has a higher rate of recurrence. Laser ablation, ultrasonic ablation, which produces a heating effect through mechanical vibration, and microwave ablation, in which tissue is ablated by the microwave energy "cooking" the adjacent tissue, have also been developed but are not widely used.

Varicose Veins

There are numerous complications of inadequately controlled hypertension that affect individuals and the entire population. Medication, diet, exercise, losing weight and meditation are all options for treatment. For a few decades, attempts have been made to stop the neural impulses that are thought to cause or make hypertension worse. The surgical sympathectomy has been helpful, but it has not been without serious side effects. As a result, the introduction of a radiofrequency ablation catheter for non-surgical renal denervation was warmly received. The most recent phase 3 study looking at catheter-based renal denervation for the treatment of resistant hypertension failed to show any significant reduction in systolic blood pressure, despite the initial use of radiofrequency-generated heat to ablate nerve endings in the renal arteries to aid in management of "resistant hypertension."

Varicose veins can be treated with a minimally invasive procedure called radiofrequency ablation. It is an alternative to the standard procedure of stripping. A radiofrequency catheter is inserted into the abnormal vein under ultrasound guidance, and the vessel is treated with radioenergy, resulting in the vein's closure. The great saphenous vein, the small saphenous vein, and the perforator veins are all treated with radiofrequency ablation. The latter are connecting veins that connect the superficial veins to the deep veins and transport blood there. The treatment of branch varicose veins typically involves ambulatory phlebectomy, sclerotherapy, or foam sclerotherapy, among other minimally invasive procedures. The large volumes tumescent anesthesia that are injected along the entire vein prior to the application of radiofrequency serve as a heat sink and absorb the heat generated by the device, reducing the likelihood of skin burn during the procedure. Early research has demonstrated a low rate of complications and a high success rate. In that main article, the clinical application of RFA in obstructive sleep apnea is discussed, with controversies and potential benefits in specific medical situations. RFA, in contrast to other electrosurgical instruments, permits extremely precise treatment targeting of the desired tissue with a precise line of demarcation. This prevents collateral damage, which is essential in the head and neck region due to the high density of major nerves and blood vessels.