Radiofrequency Group Research Articles

Influence of photobiomodulation and radiofrequency on the healing of pressure lesions in mice.

The objective of this study was to ascertain the impact of photobiomodulation and radiofrequency on the healing of pressure injuries in mice. A total of 70 animals were randomly assigned to seven experimental groups. A pressure injury was induced in the dorsal region of the mice by the application of two magnets. The photobiomodulation treatment was administered at a dosage of 3.6J per session. In the radiofrequency group, the treatment time was four minutes and the power was 22 watts. The analyses included the lesion area, infrared thermography, and the collection of material for cytokine, histological, and histochemical analyses following euthanasia. In the macroscopic analyses, the 660nm photobiomodulation group demonstrated superior outcomes in comparison to the control group. With regard to the microscopic analyses, the greatest difference between the groups was observed when TNF-α was evaluated in the photobiomodulation group. It can be observed that the groups irradiated by electrophysical means (i.e., a combination of radiofrequency with PBM 830nm-660nm) exhibited a positive influence on the repair process, with the greatest impact observed in the group irradiated by a combination of radiofrequency and 660nm photobiomodulation.

Comparative study of CT-guided radiofrequency and alcohol ablation in the treatment of primary hyperhidrosis.

This study compared the efficacy and complications of percutaneous radiofrequency ablation with anhydrous alcohol ablation of sympathetic nerves in treating hyperhidrosis of the head and palms. A retrospective analysis was conducted on 54 patients with primary hyperhidrosis in our department from June 2018 to June 2021, divided into a radiofrequency ablation group (30 cases) and an anhydrous alcohol ablation group (24 cases). Treatment outcomes were compared by analyzing the number of CT scans, effectiveness, and complications. In the radiofrequency group, symptoms of bilateral hyperhidrosis significantly improved in 24 patients, with an 80% postoperative satisfaction rate. In the alcohol ablation group, symptoms significantly improved in 19 patients postoperatively, with a 79.2% satisfaction rate. There was no statistically significant difference in effectiveness or complications between the two groups (all P > 0.05). The number of CT scans in the radiofrequency group was 4.60 ± 0.56 and 6.08 ± 0.28 in the alcohol group, showing a statistically significant difference (P < 0.05). This study concluded that both percutaneous radiofrequency ablation and alcohol ablation are effective methods for hyperhidrosis treatment, with similar effectiveness and complication rates, but the radiofrequency ablation group required fewer CT scans.

Effects of baroreceptor reflex modification on efficacy of ablation for atrial fibrillation

Abstract Background The autonomic nervous system (ANS) plays a significant role in atrial fibrillation (AF). Catheter ablation (CA) is a well-established treatment method for AF and significantly affects ANS, including baroreceptors (BR) function. However, little is known about the changes in the BR function caused by radiofrequency (RF) or cryo-energy (CB) influence the efficacy of AF ablation. Purpose To assess one-year efficacy of CA of AF in relation to BR function modification and type of ablation energy used. Methods The study group consisted of 78 patients (25 females, mean age 58±9 years) with paroxysmal AF and first CA (39 patients (RF group) and 39 (CB group)). The BR function was assessed non-invasively using tilt testing and three parameters: event count (BREC) depicting overall BR activity, slope mean depicting BR sensitivity (BRS) and BR effectiveness index (BEI). The efficacy of CA was assessed at 3, 6, and 12 months after CA using 24-hour Holter ECG recordings and dedicated scale (University of Toronto Atrial Fibrillation Severity Scale (AFSS)). Results After CA, BR function decreased in the whole group (mean BREC 12.0±3.0-22.0 vs 6.0±3.0-18.0, p=0.004; mean BRS 4.8±3.6-6.8 vs 4.0±3.0-5.8, p=0.014; mean BEI 18.7±8.3-27.4 vs 12.0±5.1-21.0, p=0.009). BREC was significantly more decreased in the CB vs RF (mean 12.0±3.0-22.0 vs 6.0±3.0-18.0, p=0.004). Similar trend was noted for BRS and BEI. On repeated Holter ECG monitorings efficacy of CB and RF was similar (89.7% vs 82.9% p=0.502, 89.7 vs 85.7%; p=0.727 and 84.6 vs 80%; p=0.602, respectively). According to AFSS, the AF symptoms were significantly reduced in both groups (CB baseline vs 3, 6 a and 12 months, respectively (median): 6.0 (IQR 2.0 – 13.0) vs 2.5 (IQR 1.0 – 4.0), p&amp;lt;0.001; 6.0 (IQR 2.0 – 13.0) vs 1.5 (IQR 0.0 – 4.0), p&amp;lt;0.001; 6.0 (IQR 2.0 – 13.0) vs 1.5 (IQR 0.0 – 4.0), p=0.002; RF baseline vs 3, 6 and 12 months, respectively (median): 10.5 (IQR 5.0 – 14.0) vs 7.0 (IQR 1.0 – 12.0), p=0.173; 10.5 (IQR 5.0 – 14.0) vs: 6.0 (IQR 2.0 – 12.0), p=0.015; 10.5 (IQR 5.0 – 14.0) vs 6.5 (IQR 2.0 – 12.0), p=0.005). After the adjustment for baseline there was no significant differencies between both groups (Table). Conclusions CA significantly affected BR function. These changes were more pronounced following CB than RF CA. However, the efficacy of RF and CB was similar.

Association between ablation-induced baroreceptor reflex modification and procedure efficacy in patients with atrial fibrillation.

The autonomic nervous system (ANS) plays a significant role in atrial fibrillation (AF). Catheter ablation (CA) is a well-established treatment method for AF and significantly affects the ANS, including baroreceptor (BR) function. However, little is known about the changes in BR function caused by radiofrequency (RF) or cryoballoon energy (CB) and its impact on future AF recurrences. To assess 1-year efficacy of CA of AF in relation to BR function modification and type of ablation energy used. The study group consisted of 78 patients (25 females, mean age 58 ± 9 years) with paroxysmal AF and first CA (39 patients in the RF group and 39 in the CB group). The BR function was assessed non-invasively, using tilt testing before and after CA, and three BR parameters were calculated: event count (BREC) depicting overall BR activity, slope mean depicting BR sensitivity (BRS), and BR effectiveness index (BEI). The efficacy of CA was assessed during 1-year follow-up, which consisted of ambulatory visits and 24-h Holter ECG recordings at 3, 6, and 12 months after CA. The quality of life was assessed by using a dedicated scale [University of Toronto Atrial Fibrillation Severity Scale (AFSS)]. The two groups did not show differences in terms of clinical or demographic data. One-year follow-up was completed for 35 (89.7%) patients from the CB group and for 34 (87.2%) from the RF group. The rates of efficacy of CB and RF were similar [31/35 (88.6%) vs. 26/34 (76.5%), respectively]. After CA, the BR function decreased in both groups, with a significantly greater decrease in the CB group. The changes in BR parameters were similar in both responders and non-responders after CA in the whole group [BREC 10.0 (2.0-24.0) vs. 12.0 (4.0-21.5), p = 0.939; BRS 5.4 (3.7-6.5) vs. 4.8 (3.6-7.2), p = 0.809; BEI 24.8 (15.9-27.4) vs. 17.5 (8.9-27.5), p = 0.508, respectively]. According to the AFSS, the AF symptoms were significantly reduced in both groups to a similar extent. CA for AF significantly decreased the BR function, especially in patients undergoing CB. There was no correlation between CA-induced changes in BR parameters and ablation outcome.

Effects of 4.9 GHz Radiofrequency Field Exposure on Brain Metabolomic and Proteomic Characterization in Mice.

Electromagnetic exposure has become increasingly widespread, and its biological effects have received extensive attention. The purpose of this study was to explore changes in the metabolism profile of the brain and serum and to identify differentially expressed proteins in the brain after exposure to the 4.9 GHz radiofrequency (RF) field. C57BL/6 mice were randomly divided into a Sham group and an RF group, which were sham-exposed and continuously exposed to a 4.9 RF field for 35 d, 1 h/d, at an average power density (PD) of 50 W/m2. After exposure, untargeted metabolomics and Tandem Mass Tags (TMT) quantitative proteomics were performed. We found 104 and 153 up- and down-regulated differentially expressed metabolites (DEMs) in the RF_Brain group and RF_Serum group, and the DEMs were significantly enriched in glycerophospholipid metabolism. Moreover, 10 up-regulated and 51 down-regulated differentially expressed proteins (DEPs) were discovered in the RF group. Functional correlation analysis showed that most DEMs and DEPs showed a significant correlation. These results suggested that 4.9 GHz exposure induced disturbance of metabolism in the brain and serum, and caused deregulation of proteins in the brain.

Verification of the superiority of radiofrequency irradiation with static stretching over static stretching alone for hamstring tightness

IntroductionHealthy hamstring muscles are necessary for active living. Hamstring tightness is a widely reported problem among individuals from all levels of society. The effects of combining radiofrequency (RF) therapy with static stretching (SS) on hamstring tightness have not been investigated. Therefore, we aimed to verify the superiority of combining RF and SS over SS alone by comparing their immediate effects on hamstring flexibility. MethodsThis randomized controlled study included 33 participants with hamstring tightness. The participants were allocated to the RF (intervention; n = 17) or sham (n = 16) group. The RF group underwent SS simultaneously with RF therapy. The sham group underwent SS with sham RF (powered off). The range of motion (ROM) for knee extension and five muscle properties (tone, stiffness, elasticity, relaxation, and creep) of the lateral and medial hamstrings were measured before and after the intervention. ResultsThere was no significant difference in the ROM for knee extension (p = 0.295) between the RF and sham groups. The interaction between group and period (p > 0.05) was not significant for any of the muscle properties of the lateral and medial hamstrings besides lateral hamstring elasticity (p = 0.001). ConclusionRF therapy in conjunction with SS for hamstring tightness produced different changes in muscle properties compared with SS alone. However, these changes did not produce differences in the ROM for knee extension.

Comparative study in treatment of acne scars fractional carbon dioxide laser versus micro needling fractional radio frequency - A retrospective study.

Efficacy of fractional carbon dioxide laser and microfractional radiofrequency in treatment of acne scars is well substantiated. The objective of this study was to compare the efficacy and safety of carbon dioxide laser versus microfractional radiofrequency in treatment of acne scars in skin type 3,4. Thirty-two patients of skin types 3-4 with grade 3 and 4 atrophic acne scars, of which 16 were treated with fractional carbon dioxide (CO2) laser and 16 were treated with microfractional radiofrequency were retrospectively analyzed. All patients received either treatment 4 sessions at an interval of 4-6 weeks. Objective assessment was done with qualitative and quantitative Goodman and baron acne scar grading system by assessment of photographs at baseline and 3 months after last session. All the data collected were entered in a Microsoft Excel worksheet and analyzed using R Software R-4.2.1. The study variables acne scar grades were described using frequency with percentage, acne scar scores were described using Mean with Standard deviation, and Median with interquartile range (IQR) (Q1-Q3). Since the data were ordinal, which is non-normal, hence, non-parametric tests are applied. To compare grades between the groups, Mann-Whitney U-test was applied. There was no difference in the last session (after the treatment) between the groups, the Mann- Whitney U-test was 109.5 with P-value of 0.484 >0.05. Therefore, there was no statistically significant difference between the microfractional radiofrequency and carbon dioxide laser group. There were 2 (12.5%) cases reported with post-inflammatory hyperpigmentation in the CO2 laser group and zero cases in the microfractional radiofrequency group.

A Retrospective Review Comparing Renuvion Helium Plasma Radiofrequency with BodyTite Bipolar Radiofrequency after Liposuction or Body Contouring.

Driven by demand for nonexcisional alternatives to address lax skin following liposuction, various energy-based technologies have become available. Helium plasma radiofrequency (RF) and bipolar RF have gained prominence. These technologies have distinctly different methods of action and indications, potentially influencing procedural safety and duration. Conducted to collect and evaluate real-world procedure and safety data, this retrospective, single-center, contiguous series study included patients who underwent either helium plasma RF or bipolar RF following a liposuction or body contouring procedure. The helium plasma RF group (N = 229) averaged 4.9 concurrent procedures, whereas the bipolar RF group (N = 236) averaged 4.4 concurrent procedures. The total treatment time, including concurrent procedures, was 182 minutes for the helium plasma RF group and 196 minutes for the bipolar RF group. The findings from the subanalysis group (n = 9) indicated that the treatment time for the helium plasma RF side of the body was 50% shorter than the bipolar RF side. A statistically significant difference in adverse events by group was observed. There were 45 events in 34 patients for helium plasma RF and 93 events in 62 patients for bipolar RF. Notably, fewer occurrences of burns, hematoma, hypertrophic scar, and seroma were reported for helium plasma RF compared with bipolar RF. The analysis reveals a notable difference in the occurrence of adverse events, with statistically significantly fewer incidents observed for helium plasma RF compared with bipolar RF. Data suggests that helium plasma RF exhibits shorter durations in the operating room compared with bipolar RF, suggesting increased procedural efficiency.

Computed Tomography-Guided Dorsal Root Ganglion Ozone Injection Combined With Pulsed Radiofrequency for Acute Herpes Zoster Neuralgia Treatment of Middle-aged and Elderly People: A Randomized, Double-blinded, Controlled Trial.

To investigate the efficacy and safety of pulsed radiofrequency of the dorsal root ganglion combined with ozone injection for treating acute herpes zoster (HZ) neuralgia in middle-aged and elderly adults. A total of 164 middle-aged and elderly patients with acute HZ were randomly assigned to 2 groups: the pulsed radiofrequency combined with ozone injection group (group A) and the pulsed radiofrequency group (group B). The therapeutic effects were evaluated using Numeric Rating Scale (NRS) scores and the average doses of gabapentin (mg/d) preoperatively and 1 day, 2 weeks, 4 weeks, 12 weeks, and 24 weeks postoperatively. The incidence of clinically significant postherpetic neuralgia (PHN) and complications in the 2 groups were recorded. The data showed that the NRS scores and the doses of gabapentin after treatment were significantly lower when compared with the baseline values in both groups. Compared with group B, the NRS scores and the doses of postoperative gabapentin were significantly lower in group A. The incidence of PHN was significantly lower at weeks 4, 12, and 24 in group A than in group B. No adverse reactions occurred in either of the 2 groups post-treatment. The results indicated that ozone injection in the dorsal root ganglion combined with pulsed radiofrequency therapy was more effective in treating acute HZ neuralgia in middle-aged and elderly adults. It provides patients with longer-lasting pain relief, decreased incidence of PHN and the doses of medication, and improved quality of life than with Pulsed Radiofrequency treatment.

Evaluation of microembolic signals on carotid ultrasound during pulmonary vein isolation with high-power short-duration and cryoballoon ablations: When and where do bubble and solid emboli arise?

The underlying risks of asymptomatic embolization during high-power short-duration (HPSD) ablation for atrial fibrillation remain unclear. We aimed to evaluate microembolic signals (MESs) during HPSD ablation with power settings of 50and 90 W in comparison with those during cryoballoon (CB) ablation using a novel carotid ultrasound-Doppler system that classifies solid and air bubble signals using real-time monitoring. Forty-seven patients underwent HPSD ablation using radiofrequency (RF), and 13 underwent CB ablation. MESs were evaluated using a novel pastable soft ultrasound probe equipped with a carotid ultrasound during pulmonary vein isolation. We compared the detailed MESs and their timing between RF and CB ablations. The number of MESs and solid signals were significantly higher in the RF group than in CB group (209 ± 229 vs. 79 ± 32, p = .047, and 83 ± 89 vs. 28 ± 17, p = .032, respectively). In RF ablation, the number of MESs, solid, and bubble signals per ablation point, or per second, was significantly higher at 90 W than at 50 W ablation. The MESs, solid, and bubble signals were detected more frequently in the bottom and anterior walls of the left pulmonary vein (LPV) ablation. In contrast, many MESs were observed before the first CB application and decreased chronologically as the procedure progressed. Signals were more prevalent during the CB interval rather than during the freezing time. Among the 28 patients, 4 exhibited a high-intensity area on postbrain magnetic resonance imaging (MRI). The MRI-positive group showed a trend of larger signal sizes than did the MRI-negative group. The number of MESs was higher in the HPSD RF group than in the CB group, with this risk being more pronounced in the 90 W ablation group. The primary detection site was the anterior wall of the LPV in RF and the first interval in CB ablation.

Clinical outcomes of radiofrequency ablation using a radiofrequency needle device for varicose ulcer: A non-randomized controlled prospective study.

To evaluate the short-term clinical outcomes of radiofrequency ablation (RFA) using a radiofrequency (RF) needle device for varicose ulcers. From September 2020 to September 2021, a total of 80 patients with varicose ulcers were included in this study. Based on the different surgical methods, the patients were divided into RF group and control groups, with 40 cases in each group. In the RF group, RFA was performed using an RF needle device and foam sclerotherapy was used for superficial veins. The control group was treated with conventional high-ligation stripping. The surgical data, hospitalization data, clinical efficacy, and postoperative complications of two groups were compared. Meanwhile, the correlation between RBC, HB, HCT, and ulcer healing time was analyzed. Compared to the control group, RF group had shorter surgery time, duration in the hospital, and less intraoperative bleeding (p < .05). The VCSS and CIVIQ scores in RF group were significantly higher than that in control group (p < .05). The healing time of ulcers was shorter in the RF group (x2 = 19.766, p = .000). The RF group had fewer postoperative complications. There was a positive correlation between RBC, HB, and HCT, and ulcer healing time (p < .05). The use of the RF needle device for RFA to treat patients with varicose ulcers showed acceptable short-term clinical outcomes with less incidence of trauma, faster recovery, and fewer complications.

Efficacy and safety of ultrasound-guided pulsed radiofrequency in the treatment of the ophthalmic branch of postherpetic trigeminal neuralgia.

To investigate the efficacy and safety of ultrasound-guided pulsed radiofrequency (PRF) targeting the supraorbital nerve for treating the ophthalmic branch of postherpetic trigeminal neuralgia. A retrospective cohort study was conducted involving patients who presented at the Department of Pain, Affiliated Hospital of Southwest Medical University from January 2015 to January 2022. The patients were diagnosed with the first branch of postherpetic trigeminal neuralgia. In total, 63 patients were included based on the inclusion and exclusion criteria. The patients were divided into the following two groups based on the treatment method used: the nerve block (NB) group (n = 32) and the PRF + NB group (radiofrequency group, n = 31). The visual analog scale (VAS) score, Pittsburgh Sleep Quality Index (PSQI) score, and pregabalin dose were compared between the two groups before treatment, 1 week after the procedure, and 1, 3, and 6 months post-procedure, and the complications, such as local infection, local hematoma, and decreased visual acuity, were monitored post-treatment. No significant difference was found in terms of pretreatment age, sex, course of disease, preoperative VAS score, preoperative PSQI score, and preoperative pregabalin dose between the two groups (P > 0.05). The postoperative VAS score, PSQI score, and pregabalin dose were significantly decreased in both groups. Furthermore, significant differences were found between the two groups at each preoperative and postoperative time point (P < 0.05). The VAS score was lower in the radiofrequency group than in the NB group at 1, 3, and 6 months, and the difference was statistically significant (P < 0.05). The PSQI score was lower in the radiofrequency group than in the NB group at 1 week, 1, 3, and 6 months post-procedure, and the difference was statistically significant (P < 0.05). The dose of pregabalin was lower in the radiofrequency group than in the NB group at 1 week, 1, 3, and 6 months post-procedure, and the difference was statistically significant at 3 and 6 months (P < 0.05). After 6 months of treatment, the excellent rate of VAS score in the radiofrequency group was 70.96%, and the overall effective rate was 90.32%, which was higher than that in the NB group. The difference in the efficacy was statistically significant (P < 0.05). PRF targeting the supraorbital nerve can effectively control the pain in the first branch of the trigeminal nerve after herpes, enhance sleep quality, and reduce the dose of pregabalin. Thus, this study shows that PRF is safe under ultrasound guidance and is worthy of clinical application.

The efficacy and safety of additional pulmonary vein antrum substrate ablation after cryo-ablation in patients with persistent atrial fibrillation

Abstract Background Cryo-ablation for persistent atrial fibrillation (PeAF) has been reported to be safe and comparable to radiofrequency (RF) ablation, but the outcome was not satisfactory. AF drivers mapping after pulmonary vein isolation (PVI) was reported to be widely identified in left atrium (LA). On the other hand, extensive drivers ablation is considered to have limited durability of PVI compared to cryo-ablation. Purpose This study sought to investigate the efficacy and safety of additional PV antrum substrate ablation after PVI by cryo-ablation in patients with PeAF. Methods A total of 122 consecutive patients (90 men, 32 women) who underwent ablation between January 2021 and July 2023 for PeAF, except for patients with long standing ≥10years AF, or large LA diameter ≥55mm, or low left ventricular ejection fraction (LVEF) ≤35% with organic heart disease, were divided into three groups; cryo-ablation alone (Cryo group; 30 patients), RF ablation alone guided by AF drivers mapping (RF group; 52 patients), or cryo-ablation plus RF for AF drivers (Cryo+RF group; 40 patients). AF drivers mapping was performed by real-time phase mapping system or complex fractionated electrograms (Figure1). The outcome of freedom from atrial tachy-arrhythmia lasting longer than 30 seconds without anti-arrhythmic drugs after three months blanking period of a single procedure was compared among groups. Results Baseline characteristics of patients (68±9.2 years old, LVEF 57±9.9 %, LA diameter 43±5.4 mm, persistent AF duration 9.4±18 months, long standing ≥1year AF 17 patients) were similar in three groups. The incident of recurrence of atrial tachy-arrhythmia in Cryo+RF group was significantly lower compared with Cryo group (15% vs. 37%; p=0.014) and RF group (15% vs. 25%; p=0.28) (Figure2). There was no serious complication in three groups. Conclusion Additional drivers RF ablation after cryo-ablation for PeAF is safe and associated with a significant reduction in atrial tachy-arrhythmia recurrence.Figure 1Figure 2

The impact of additional radiofrequency ablation for atrial fibrillation substrates using with ExTRa-Mapping analysis after Cryo-ablation in patients with persistent atrial fibrillation

Abstract Background Pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF) is well established. Cryo-ablation for persistent AF has been reported to be safe and effective and comparable to radiofrequency (RF) ablation in long term arrhythmia-free survival, but the outcome is limited. Phase mapping using software of ExTRa-Mapping is a new tool to clarify the real-time imaging of the AF wave dynamics. Purpose We investigated the distribution of rotors of left atrium (LA) after PVI by Cryo-ablation, and the efficacy and safety of additional RF ablation for AF substrates (rotor modification) after Cryo-ablation. Methods A total of 50 patients who underwent persistent AF ablation in our hospital were enrolled. The Cryo-ablation alone group (Cryo group; n=25) and the Cryo-ablation + additional RF substrates ablation group (Cryo+RF group; n=25) were randomly divided. First, PVI with Cryo-ablation was performed. Second, if AF did not term after PVI, the rotor of LA were analyzed using the NAVX and ExTRa-Mapping system. In Cryo+RF group, the extensive RF ablation of the PV antrum to modify the rotor area were performed (Abstract Picture 1). The recurrence rate of any atrial tachy-arrhythmia without anti-arrhythmic drugs and safety were evaluated in both groups. Results The patient characteristics (69 ± 9.2 years old, body-mass index 24 ± 3.2 kg/m2, LA diameter 43 ± 5.1 mm, left ventricular ejection fraction 60 ± 7.8 %, persistent AF duration 4.2 ± 5.1 months) did not differ between the both groups. The distribution of rotors of LA were predominantly present in the anterior (n = 36) and inferior (n = 27) walls of the LA, with only a few in the posterior wall (n = 7) in the both groups. In Cryo+RF group, except for 4 cases in which AF was termed by PVI or a rotor was not detected, extensive RF modification in anterior antrum of right pulmonary vein was performed in 18 of 21 cases. In an average follow-up of 482 ± 273 days, the recurrence rate of any atrial tachy-arrhythmia was significantly lower in Cryo+RF group compared with Cryo group (p=0.029, Abstract Picture 2). No serious complications occurred in both groups. Conclusion Additional extensive RF ablation of the PV antrum to modify the Rotor area resulted in a lower recurrence rate in patients with persistent AF.Modify the rotor areaRecurrence rate

Biochemical markers of neuro-myocardial damage after pulmonary vein isolation: the effect of different energy sources

Abstract Background Pulmonary vein isolation (PVI) by thermal energy, both radiofrequency (RF) and cryoenergy(Cryo), is associated with a significant release of myocardial and collateral neural injury markers. Damage to periatrial ganglionated plexi also results in a substantial change in cardiac autonomic regulations. On the contrary, pulsed electric field (PEF) energy tends to spare cardiac neural tissue. Purpose To quantify the impact of different ablation energy sources that are used for PVI on neuro-myocardial damage by the assessment of specific biomarkers. Methods A study enrolled 85 patients with paroxysmal atrial fibrillation who underwent PVI (age: 61 ± 12 years, 74% males). In 23 patients, RF energy was delivered by the irrigated-tip catheter, while 30 patients were ablated using a second-generation cryoballoon catheter. In 32 patients, PVI was performed using a multipolar pentaspline catheter and PEF energy. Peripheral venous blood samples for assessing the plasmatic levels of S100 calcium-binding protein B (S100B), neuron-specific enolase (NSE), high-sensitivity troponin I and T (hsTnI and hsTnT) were obtained before, immediately after the PVI, and the next day (usually 18-24 hours after the procedure). Study groups were compared regarding absolute biomarker levels and hsTnT/S100B ratio (a surrogate of cardioselectivity). Results Following successful PVI, a significant increase in plasma levels of all biomarkers was observed: DhsTnT = 1040±434 ng/L, 1731±830 ng/L and 1010±397 ng/L; DhsTnI = 1504±918 ng/L, 16464±11911 ng/L and 10789±7589 ng/L; DS100B: 0.04±0.02 mg/L, 0.03±0.04 mg/L and 0.14±0.08 mg/L; DNSE: 34±72 ng/mL, 27±53 ng/mL and 45±52 ng/mL (all with P &amp;lt;0.001) for RF, PEF and Cryo groups, respectively. A direct comparison of maximal biomarker levels between study groups is depicted in the Figure. The hsTnT/S100B ratio was 23±14, 12±6, and 6±3 in PEF, RF, and Cryo groups, respectively (ANOVA P &amp;lt;0.01), indicating that PEF was 1.9-times and 3.8-times more cardioselective than RF and Cryo, respectively. Following the PVI, the heart rate accelerated by 2±8, 13±14, and 9±11 bpm in the PEF, RF, and Cryo groups, respectively. No correlation was observed between S100B release and HR acceleration (R = 0.07, P = 0.55). Conclusion Compared to thermal energy sources, PEF energy induces more specific damage to cardiomyocytes than cardiac nerves. There was no correlation between S100B release and HR acceleration.

Direct epicardial validation of posterior wall isolation in persistent atrial fibrillation: pulsed field versus radiofrequency ablation

Abstract Background Lesion transmurality is an important determinant of durable effectiveness of catheter ablation (CA) for atrial fibrillation (AF). The impact of different energy sources on the achievement of transmural left atrial (LA) ablation has not been explored so far. Purpose We sought to compare the transmurality associated with pulsed field ablation (PFA) and radiofrequency (RF) ablation of LA posterior wall (PW) among patients with persistent AF. Methods Eight patients (mean age, 70±7 years; 88% male) undergoing CA for persistent AF with PW ablation and adjunctive high-density epicardial mapping were included in a multicenter international registry. In four patients, PW ablation was performed using PFA, while in the remaining four, RF energy was used with high/very-high-power short-duration settings. The primary study outcome was transmural PW isolation (PWI) with endocardial-only ablation. Results A trend towards shorter times required to complete endocardial PW ablation was observed with PFA compared to RF (9±1 vs 11±2min, p=0.065). At endocardial mapping, apparent PWI was observed in all cases. However, transmural PWI after endocardial-only ablation was demonstrated in each patient in the PFA group, but only in one RF case, in whom 50 Watt/≥10 sec settings were used (100% vs 25%, p=0.143). Interestingly, in three patients in the RF group, endocardial ablation resulted in conversion of AF into atypical flutter, which could be successfully terminated by epicardial ablation. Conclusions We observed a trend towards greater transmurality with PFA compared to high/very-high power RF ablation in the region of septopulmonary bundle. This observation may have potential implications on clinical outcomes after endocardial AF CA.

The CellFX Percutaneous Electrode System for Nanosecond Pulsed Field Ablation.

The purpose of this study was to demonstrate the safety and performance of the CellFX Percutaneous Electrode for delivering nanosecond pulsed field ablation (nsPFA) energy to soft tissues. Three different porcine tissue types were treated, namely, liver, kidney, and skeletal muscle, at treatment levels of three times greater than clinical treatment levels. The histological characteristics of the ablation zone for each of these tissues compared with that of radiofrequency (RF) ablation on day 0 and 2 days post-treatment. Ablation zone dimensions were measured during gross necropsy after tetrazolium chloride staining and compared between the nsPFA and RF groups at 2 days post-ablation. The CellFX system successfully achieved ablation and necrosis of all treatment sites in all target tissues. No evidence of thermal effects or collagen degeneration was found at any of the nsPFA treatment sites. Overall systemic tolerability was evidenced by the absence of clinically significant changes in urinalysis and serum chemistry before and after treatments.

Bipolar Radiofrequency and Non-Crosslinked Hyaluronic Acid Plus Calcium Hydroxyapatite in the Treatment of Stress Urinary Incontinence.

Stress urinary incontinence (SUI) causes both physical and psychological problems to women and their partners. Recently, vaginal radiofrequency (RF) application, as well as the administration of non-crosslinked hyaluronic acid (NCLHA) together with calcium hydroxyapatite (CaHA), has attracted attention for SUI treatment. The current, comparative study evaluated the efficacy and safety of these technologies acting separately and in a combined treatment. Sixty women with mild to moderate SUI, aged between 46 and 76 years (mean age 63.2) were divided into three groups intended for different treatments: group I, RF vaginal treatment only, group II, NCLHA plus CaHA periurethral injection only, group III, combined treatment including a single periurethral injection of NCLHA plus CaHA followed by four vaginal applications of RF at intervals of 3-5 days. The clinical effects of the treatments were evaluated by ICIQ-LUTSqol (Polish version) and UDI-6. The obtained results suggest that the symptoms of SUI and the quality of life of the patients improved significantly in each group after the therapies compared to the pre-treatment levels and were more persistent in the third HA + RF group compared to the HA or the RF group.

Comparison of greater occipital nerve blockade with radiofrequency and steroid in chronic migraine

ObjectivesThe study aims to retrospectively compare steroid and radiofrequency treatments for the greater occipital nerve(GON) under ultrasound guidance in chronic migraine. MethodsMonthly average headache attack frequency, attack duration, visual analog scale(VAS) and the number of days analgesics were taken were recorded. Under ultrasound guidance, GON block was administered once a week for a total of four sessions. In the final session, 4 mg of dexamethasone was added to the local anesthetic for the steroid group (n:26). Pulsed radiofrequency (RF) treatment was applied to the RF group (n:25) just before the last session of the GON block. The pain course in the week following the procedure monthly average headache attack frequency, attack duration, VAS and the number of days analgesics were taken in a month were compared for both groups at 1–3–6 months. ResultsIn the first month, a statistically significant decrease in attack frequency was observed in the RF group. However, no statistically significant differences were found between the groups in other findings at different time intervals. A significant decrease headache attack duration,VAS, and the number of days analgesics were taken in a month was observed in both treatment groups. Both treatments were found to be effective, but the effect size of the treatment was higher in the RF group compared to the steroid group. ConclusionAlthough the results were better in the group receiving pulsed RF treatment, except for the attack frequency in the first month, no statistically significant superiority of one treatment method over the other was determined.

Evaluating the Effectiveness of Radiofrequency Therapy and Manual Pelvic Fascial Release in Treating Myofascial Pelvic Pain.

Myofascial pelvic pain (MFPP), characterized by sensitive trigger points in the pelvic floor muscles, leads to chronic pain and affects various aspects of life. Despite the availability of different treatment modalities, there is limited comparative research on their effectiveness. This study compares radiofrequency (RF) therapy and myofascial manual therapy (MMT) in treating MFPP. We aimed to evaluate pelvic floor muscle strength changes, clinical symptoms, and patient comfort during treatment. The study involved 176 participants, divided equally into RF and MMT groups. We assessed pelvic floor pain using the Visual Analogue Scale (VAS), muscle strength using the Modified Oxford Scale (MOS) and surface electromyography (sEMG), clinical symptom improvement through questionnaires, and patient discomfort during treatment. Both RF and MMT groups significantly reduced pelvic floor and paraurethral muscle pain (VAS scores, p < 0.001). RF treatment significantly decreased vaginal laxity in its group (p < 0.001), with no notable change in the MMT group (p = 0.818). RF therapy also resulted in greater patient comfort than MMT (p < 0.001). Although both treatments improved clinical symptoms, there was no significant difference between the two (p = 0.692). MOS scores and pelvic floor sEMG values showed no significant differences between the groups before and after treatment (p > 0.05). Both RF and MMT effectively alleviate pelvic floor pain and improve clinical symptoms in MFPP patients. RF therapy, however, offers additional benefits in reducing vaginal laxity and enhancing treatment comfort.