radiofrequency ablation radiofrequency ablation radiofrequency ablation (rfa), also called fulguration, is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from medium frequency alternating current (in the range of 350–500 khz). rfa is generally conducted in the outpatient setting, using either local anesthetics or twilight anesthesia. when it is delivered via catheter, it is called radiofrequency catheter ablation. radiofrequency ablationtissue ablation using radiofrequency.specialtyinterventional radiologyicd-9-cm01.32, 04.2, 37.33, 37.34, 60.97meshd017115 two important advantages of radio frequency current (over previously used low frequency ac or pulses of dc) are that it does not directly stimulate nerves or heart muscle and therefore can often be used without the need for general anesthesia, and that it is very specific for treating the desired tissue without significant collateral damage; due to this, it is gaining in popularity as an alternative for eligible patients who do not want to undergo surgery. documented benefits have led to rfa becoming widely used during the 21st century. rfa procedures are performed under image guidance (such as x-ray screening, ct scan or ultrasound) by an interventional pain specialist (such as an anesthesiologist), interventional radiologist, otolaryngologists, a gastrointestinal or surgical endoscopist, or a cardiac electrophysiologist, a subspecialty of cardiologists. tumors ct scan showing radiofrequency ablation of a liver lesion rfa may be performed to treat tumors in the lung, liver, kidney, and bone, as well as other body organs less commonly. once the diagnosis of tumor is confirmed, a needle-like rfa probe is placed inside the tumor. the radiofrequency waves passing through the probe increase the temperature within tumor tissue, which results in destruction of the tumor. rfa can be used with small tumors, whether these arose within the organ (primary tumors) or spread to the organ (metastases). the suitability of rfa for a particular tumor depends on multiple factors. rfa can usually be administered as an outpatient procedure, though may at times require a brief hospital stay. rfa may be combined with locally delivered chemotherapy to treat hepatocellular carcinoma (primary liver cancer). a method currently in phase iii trials uses the low-level heat (hyperthermia) created by the rfa probe to trigger release of concentrated chemotherapeutic drugs from heat-sensitive liposomes in the margins around the ablated tissue as a treatment for hepatocellular carcinoma (hcc). radiofrequency ablation is also used in pancreatic cancer and bile duct cancer. rfa has become increasingly important in the care of benign bone tumors, most notably osteoid osteomas. since the procedure was first introduced for the treatment of osteoid osteomas in the 1990s, it has been shown in numerous studies to be less invasive and expensive, to result in less bone destruction and to have equivalent safety and efficacy to surgical techniques, with 66 to 95% of people reporting freedom from symptoms. while initial success rates with rfa are high, symptom recurrence after rfa treatment has been reported, with some studies demonstrating a recurrence rate similar to that of surgical treatment. rfa is also increasingly used in the palliative treatment of painful metastatic bone disease in people who are not eligible or do not respond to traditional therapies ( i.e. radiation therapy, chemotherapy, palliative surgery, bisphosphonates or analgesic medications). cardiology