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Chapter-10 Radiofrequency Ablation: Principles and Biophysics

BOOK TITLE: Practical Cardiac Electrophysiology

Author
1. Friedman Paul M
2. Deshmukh Abhishek
ISBN
9789386056795
DOI
10.5005/jp/books/13028_11
Edition
1/e
Publishing Year
2017
Pages
20
Author Affiliations
1. University of Texas Houston Medical School, Houston, Texas, USA; Weill Cornell Medical College, The Methodist Hospital, New York, NY, USA
2. Mayo Clinic, Rochester, MN, USA
Chapter keywords
Radiofrequency ablation, radiofrequency energy, effective lesion formation, electrode contact pressure, impedance monitoring, coagulum formation, atrioesophageal fistula

Abstract

This chapter discusses the principles and biophysics of radiofrequency ablation (RFA). RFA is the highly effective, most studied and commonly used energy source for ablation of cardiac arrhythmias. RF energy is a form of alternating electrical current that generates a lesion in the heart by electrically heating the myocardium. RF current is typically delivered in a unipolar fashion from an intracardiac electrode catheter to a dispersive grounding pad placed on the skin. Current methods of RF energy titration allow safe and effective catheter ablation for the treatment of cardiac arrhythmias. Coagulum formation, myocardial boiling, cardiac perforation, collateral damage and atrioesophageal fistula are the different complications of RF ablation. Preventions of these complications are also provided in this chapter. Pathophysiology of lesion formation by RF ablation, determinants of effective lesion formation, monitoring and titration of RF energy delivery, and energy delivery in specific anatomical locations are also discussed in this chapter.

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