Radiofrequency (RF) ablation of painful bone tumours and metastasis has quickly progressed from an experimental procedure to an established minimally invasive method for pain control. This review will describe the physics behind RF ablation technology. Osteoid osteomas were the first primary bone tumours to be treated in this manner, establishing RF ablation as the treatment modality of choice. A more recent development involves the use of RF ablation in painful bone metastases. In this setting, RF ablation complements radiation therapy. Its advantage lies in a more rapid onset of pain reduction (often at least by 2 points on a 10-point scale), and that radiation therapy can be employed concomittantly. It is important to remember that the aim of RF ablation in painful bone metastases is not curative, but palliation.
Catheter Ablation - Methods

Factors influencing the temperature-sensing accuracy of an ablation catheter are analyzed, in this paper, from the two aspects of the thermocouple temperature sensor, which are the TC length and the TC hole's diameter of the ablation electrode. Meanwhile, differences between products from different companies are given too.
Catheter Ablation ; methods ; Electrodes ; Temperature

Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans

Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans

OBJECTIVETo investigate the effectiveness and advantages of the Carto merge technique in guiding radiofrequency catheter ablation (RFCA) of permanent atrial fibrillation (AF).

METHODSA total of 15 patients with permanent AF underwent RFCA under guidance of the Carto merge technique. The virtual electroanatomical map of the left atrium (LA) and pulmonary veins (PVs) were reconstructed with Carto system during the procedure. Then the electroanatomical map was integrated with 3-D images of cardiac magnetic resonance angiography to form Carto merge map. Circumferential pulmonary vein ablation was performed first until complete PVs electric isolation confirmed by lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced. Finally direct current (DC) cardioversion were given if sinus rhythm did not return.

RESULTSAF were terminated spontaneously during RFCA in 2 patients, and by DC cardioversion in the remaining 13 patients. Persistent AF recurred on 24 hours, first week, and 5th week, respectively in three patients. The remaining 12 patients were all free of AF during follow-up (1-10 months). The success rate was 80% in the study.

CONCLUSIONSCarto merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping and enhance the success rate of RFCA of permanent AF.

Catheter Ablation ; methods ; Humans ; Hypertension ; surgery ; Renal Artery ; Sympathectomy ; methods

Atrial Fibrillation ; physiopathology ; surgery ; Catheter Ablation ; methods ; Humans ; Treatment Outcome

Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans ; Pulmonary Veins ; surgery

Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans ; Male

Patients with hypertrophic cardiomyopathy who experience refractory symptoms due to left ventricular outflow tract obstruction are often referred for definitive therapy consisting of either surgical myectomy or alcohol septal ablation (ASA). There currently exists clinical equipoise regarding which therapy is the most efficacious in this challenging patient population. ASA utilizes common interventional techniques usually employed to treat atherosclerotic coronary artery disease to inject small aliquots of ethanol into a branch of the appropriate septal vessel to cause necrosis of the obstructing basal septal tissue. Myocardial contrast echocardiography is used to facilitate location of the most appropriate septal branch with success determined by an acute reduction in the resting and/or provoked gradient. Recent comparative data have suggested similar rates of long and short-term mortality in when comparing patients undergoing ASA and surgical myectomy, with ASA patients experiencing a higher rate of requirement for permanent pacemakers. In addition, patients treated by both techniques appear to have similar gradient reductions and improvement in symptomatic status. Comparisons of these two methods of treatment are limited by the non-randomized nature of the studies, retrospective data collection and the allocation of higher-risk patients to ASA treatment. Concern for the wide-spread adoption of ASA to drug-resistant HCM patients is warranted due to the potential for arrhythmogenesis is a patient population already at risk for life-threatening arrhythmias. There have been case reports of such arrhythmias, however, clinical series to date have not suggested an enhanced risk of sudden cardiac death in patients treated with ASA. Definitive answers concerning which patient subsets with drug-refractory hypertrophic cardiomyopathy would benefit from the two competing therapies can only be answered by a randomized clinical trial. However, for a variety of clinical and logistical factors, such a trial is unlikely to ever be performed. For the foreseeable future, patient-specific therapy will depend on local expertise, patient comorbidities and preferences.
Cardiomyopathy, Hypertrophic ; therapy ; Catheter Ablation ; methods ; Ethanol ; therapeutic use ; Humans