Jefferson University Hospitals

Radiofrequency Ablation (RFA)

Radiofrequency ablation at Jefferson is a minimally invasive treatment of tumors of the liver, kidney, bone and lung; barrett's esophagus; varicose veins; various pain conditions; and a wide variety of disorders where the heart beats too fast or sometimes irregularly, called cardiac arrhythmia. Most people can resume their usual activities in a few days after treatment.

Treating Liver, Kidney, Bone or Lung Tumors with Radiofrequency Ablation

Interventional radiologists at Jefferson are able to destroy inoperable primary or metastatic tumors by delivering high-frequency electrical currents into the tumor via a needle electrode. This is done under local anesthesia and conscious sedation, with CT guidance. Heat is generated at the site of the lesion and destroys the tumor with almost pinpoint accuracy.

In some cases, superficial tumors can be wedged out and deeper lesions destroyed by radiofrequency ablation – helping to preserve most of the healthy tissue. Choosing the best approach depends on the number and location of the tumors. In most cases, just one RFA treatment is necessary for any given tumor. While the maximum tumor size that RFA can effectively treat has yet to be determined with certainty, the technique appears to be best suited for tumors that are smaller than 5 centimeters.

Depending on the size and number of tumors, the RFA procedure lasts between 20 minutes and 2 hours. The procedure is generally well-tolerated with minimal to no pain after treatment. Follow-up CT scans are obtained every few months to watch for tumor recurrences.

Treating Barrett's Esophagus with Radiofrequency Ablation

Radiofrequency ablation used to treat Barrett's esophagus was pioneered at Jefferson by Dr. Anthony Infantolino, director of the Barrett's Esophagus Treatment Center. On average, RFA requires four 30-minute outpatient procedures at intervals of two to three months. Side effects are minimal and the patient can return to work within days of each procedure.

In RFA, a special tool is used, composed of a catheter with a balloon at the end. The physician inflates the balloon to the size of the esophagus, and then sends an electrical charge that removes 80 to 90 percent of the diseased tissue. During the follow-up procedures, the physician uses a smaller ablation device to remove the remainder of the pre-cancerous tissue. Jefferson gastroenterologists have performed more than 1300 of these procedures, making Jefferson the regional leader in RFA.

To maximize the success of the procedure, Jefferson physicians are able to take advantage of its pathologists, diagnostic laboratories and radiology department, all highly experienced in the testing and evaluation of Barrett's esophagus and other esophageal conditions.

Treating Varicose Veins with Radiofrequency Ablation

Surgeons of the Jefferson Vascular Center perform RFA of veins as an outpatient procedure. This procedure replaces saphenous vein stripping, which is performed under general anesthesia in an operating room and often requires a one- to two-day hospitalization. RFA is performed through a single puncture hole in the skin, around the knee. It takes approximately 45 minutes and is virtually painless, requiring minimal time away from work.

Treating Heart Disorders with Radiofrequency Ablation

RFA is used to treat a wide variety of disorders where the heart beats too fast or sometimes irregularly. Examples include supraventricular tachycardia, ventricular tachycardia, atrial fibrillation and atrial flutter.

RFA involves inserting a special catheter through a vein (usually in the groin) and positioning it in the area of the heart where the fast heart rhythm originates. Application of radiofrequency energy "zaps" that region with minimal pain to cure the patient of the arrhythmia.

In contrast to long-term drug therapy, RFA attempts to provide a cure for many of the heart rhythm problems. This allows patients to avoid chronic medications and the side effect that accompany them.

Treating Chronic Pain with Radiofrequency Ablation

Pain medicine specialists of the Jefferson Pain Center offer RFA as a treatment option for various pain conditions. It destroys the nerves of the affected areas. It is commonly used for lower back pain (facet arthropathy), headache (occipital neuralgia) and pain due to entrapment neuropathy (neuroma). Patients usually undergo diagnostic nerve blocks with local anesthetics before proceeding to RFA.