Radiofrequency Ablation

What is Radiofrequency Ablation?

Radiofrequency Ablation (RFA) is a minimally invasive medical procedure that uses heat energy to destroy abnormal tissues in the digestive system. The procedure involves using a catheter that emits high-frequency energy that heats and destroys the targeted tissues. 

This procedure is performed under sedation; patients may be able to return home on the same day.

Who is Suitable for Radiofrequency Ablation?

Radiofrequency Ablation is suitable for patients with digestive system disorders such as Barrett's oesophagus with pre-cancerous changes, a condition in which the lining of the oesophagus changes due to long-term acid reflux. The condition increases the risk of developing esophageal cancer. 

What are the Benefits of Radiofrequency Ablation?

One of the primary benefits of Radiofrequency Ablation is that it is a minimally invasive procedure that does not require surgery. This means that patients experience less pain, have a shorter recovery time, and can quickly return to their daily activities. RFA is also highly effective, with a success rate of up to 98% in treating Barrett's oesophagus, and may reduce the risk of developing oesophageal cancer.

What are the Types of Radiofrequency Ablation?

There are two main Radiofrequency Ablation (RFA) types: focal and circumferential.

• Focal RFA treats small areas of abnormal tissue in the digestive system. This procedure typically uses an endoscope, allowing the doctor to see the treated area. The doctor will place a small device at the end of the endoscope that emits high-frequency energy to destroy the targeted tissues.
• Circumferential RFA, on the other hand, is used to treat larger areas of abnormal tissue. This procedure typically uses a balloon catheter inflated to cover the treated area. The catheter contains an electrode that emits high-frequency energy, destroying the abnormal tissues.

In some cases, focal and circumferential RFA may be used to treat certain digestive system disorders. The choice of the type of RFA used will depend on the size and location of the abnormal tissues being treated. Your gastroenterologist can advise on the most appropriate type of RFA for your circumstances.

Radiofrequency Ablation Procedure

Preparation Before Radiofrequency Ablation Procedure

Before an RFA procedure, patients must make several preparations to ensure the procedure is successful and safe. Here are some of the things you should do before undergoing an RFA procedure:

• You should schedule a consultation with a gastroenterologist to determine if RFA is a suitable treatment option for your condition. During the consultation, the gastroenterologist will review your medical history, perform a physical exam, and discuss the benefits and risks of RFA.
• You should inform the gastroenterologist of your medications, including prescription and over-the-counter medications, vitamins, and supplements. Some medicines may need to be adjusted or stopped before the procedure to reduce the risk of bleeding or other complications.
• You will be instructed to fast for several hours before the procedure, usually 6-12 hours. This ensures the digestive system is empty, reducing the risk of complications during the procedure.
• You may need blood tests to ensure you are healthy enough to undergo the procedure.
• RFA is performed under sedation, which can impair judgment and reflexes. You cannot drive home after the procedure, so you should arrange for someone to take you home.
• You should arrange for someone to assist with daily activities after the procedure, as you may experience discomfort and weakness.
• You should follow fasting instructions provided by the gastroenterologist, which may include not eating or drinking anything after midnight on the day of the procedure.

A successful and safe RFA procedure is ensured by following these preparation steps. It is essential to discuss any concerns or questions with your gastroenterologist before the procedure to ensure you are fully prepared.

What Happens During a Radiofrequency Ablation Procedure?

During an RFA procedure, the patient is typically under sedation to help them relax and minimise discomfort. Here are the steps involved in an RFA procedure:

• Preparation: You will be positioned on their left side, and an endoscope will be inserted into the mouth and down the oesophagus. The doctor will then use the endoscope to examine the area being treated.
• Catheter placement: Once the treated area has been identified, the doctor will insert a thin catheter through the endoscope and into the digestive system. The catheter has an electrode at its tip, emitting high-frequency energy to destroy the abnormal tissues.
• Energy delivery: Once the catheter is in place, the doctor will deliver the high-frequency energy to the targeted tissues. This process heats the tissues, destroying them and promoting healthy tissue growth.
• Monitoring: The doctor will monitor your vital signs throughout the procedure, including heart rate, blood pressure, and oxygen levels, to ensure you are stable.
• Completion: Once the procedure is complete, the doctor will remove the catheter and endoscope from your body.

After Radiofrequency Ablation Procedure

After the procedure, you are monitored briefly to ensure no immediate complications or adverse reactions to the sedation or procedure.

Radiofrequency Ablation Procedure Recovery Plan

After an RFA procedure, you require a recovery period to ensure proper healing and minimise the risk of complications.

• Rest:  You are advised to rest for the first few hours after the procedure. It is recommended to avoid strenuous activities, such as driving and operating machinery for 24 hours following the procedure.
• Medication: You may experience discomfort after the procedure, which can be managed with over-the-counter pain medications such as paracetamol. However, you should avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) as they can increase the risk of bleeding.
• You will be advised to eat soft foods and drink plenty of fluids for the first few days after the procedure. Spicy or acidic foods should be avoided as they can irritate the digestive system.
• You will be scheduled for a follow-up appointment with your gastroenterologist to monitor your recovery and ensure the procedure has succeeded. Depending on the condition and the severity of the treatment, multiple RFA procedures may be required.
• You can usually resume normal activities within a few days after the procedure but should avoid strenuous physical activities for at least 24 hours. You should avoid smoking and drinking alcohol for several days after the procedure, as these activities can irritate the digestive system.

Following the recovery plan your gastroenterologist recommends is essential to ensure proper healing and minimise the risk of complications. You should contact your gastroenterologist immediately if you experience severe or prolonged symptoms like bleeding, fever, or severe pain.

Radiofrequency Ablation Prognosis

Radiofrequency Ablation has a high success rate in treating digestive system disorders such as Barrett's oesophagus and dysplasia. Radiofrequency Ablation is usually combined with endoscopic resection of precancerous (dysplastic) tissue. The prognosis for patients who undergo RFA is generally favourable, with a significantly reduced risk of developing oesophageal cancer.

Radiofrequency Ablation Risks

As with any medical procedure, there are risks associated with Radiofrequency Ablation. Some risks include bleeding, infection, and perforation of the digestive system. However, these risks are rare and usually minor.

What if Radiofrequency Ablation is Delayed?

If Radiofrequency Ablation is delayed, it may result in the progression of the digestive system disorder, which could increase the risk of developing esophageal cancer. It is essential to consult with a gastroenterologist to determine the appropriate course of action if RFA is delayed.

What is the Cost of Radiofrequency Ablation?

The cost of Radiofrequency Ablation varies depending on several factors, including the location, the type of treatment required, and the patient's insurance coverage. Generally, RFA is expensive, and patients should consult with their gastroenterologist to determine the cost and the available payment options.