Radiofrequency, a common energy used in ablation therapies, is used for treating damaged, diseased, or malfunctioning tissue with minimally invasive procedures. However, recent developments are leading to frequent comparisons of pulsed field ablation vs radiofrequency ablation; pulsed field ablation has become an attractive option in some cases over radiofrequency ablation.
While radiofrequency ablation uses heat to destroy the targeted tissue, pulsed field ablation takes a different approach by using high voltage, nano- to microsecond pulses to selectively damage cells through apoptosis.
The result is a non-thermal method for killing tissue. This non-thermal method reduces the risk of harming nearby healthy tissue, making pulsed field ablation (PFA) an appealing option in sensitive areas, such as the heart, where nearby tissues need to be spared.
In this article, we’ll dive deeper into the differences between PFA and radiofrequency ablation (RFA), exploring:
- How each method works
- Key differences between the two
- How medical devices are integral to RFA and PFA
What is Ablation? Understanding the Basics of Medical Ablation Techniques
The goal of ablation therapy is to kill problematic tissue, such as tumors, irregular heart tissue causing arrhythmias, or other diseased areas. It is often desirable to minimize damage to surrounding healthy tissue while ablating, including nearby organs, vasculature, or nerves.
It uses energy sources that can be applied to affected tissue, such as radiofrequency, microwave, ultrasound, or other energy waves.
Ablation procedures are often minimally invasive, involving small incisions or catheter insertions rather than high-risk and invasive surgeries.
Common Types of Medical Ablation
- Radiofrequency Ablation (RFA) uses heat generated by radiofrequency energy to destroy tissue. RFA is used to treat atrial fibrillation and other cardiac arrhythmias, liver tumors, and chronic pain conditions like nerve pain (e.g., facet joint pain).
- Laser Ablation employs focused light to burn away targeted tissue. Often used in dermatology for skin conditions, in neurosurgery for treating brain tumors, and in ophthalmology for vision correction (e.g., LASIK).
- Microwave Ablation involves the use of microwave energy to generate heat for tissue destruction and is primarily used to treat liver, lung, and kidney tumors.
- Pulsed Field Ablation (PFA) is a newer method that uses electrical pulses to create tiny pores in cells, leading to cell death through electroporation. PFA is primarily used for treating atrial fibrillation and other cardiac arrhythmias, with emerging uses in other areas being explored.
Both radiofrequency ablation and pulsed field ablation are commonly used to treat atrial fibrillation, a condition where the heart beats irregularly.
While RFA has been the standard for decades, PFA is a more recent innovation showing promise for more precise treatments with fewer risks and potentially better outcomes. Let’s explore the differences in these two technologies.
“While RFA has been the standard for decades, there has been recent innovation in PFA showing promise for more precise treatments with fewer risks and potentially better outcomes.” said Jeff Chininis, Engineering Director, Vantage MedTech.
Take the Lead in Medical InnovationTurn your idea for a better ablation medical device into reality. Build with proven platforms and industry expertise. |
How Does Radiofrequency Ablation Work?
RFA works by using radiofrequency energy to generate heat that destroys targeted tissue. The process begins with the insertion of a catheter, percutaneous probe, or other applied device, typically guided to the problem area using imaging technology such as X-rays or ultrasound.
Once in position, the applied device emits radiofrequency energy through an electrode in the form of high-frequency alternating current. This current causes the surrounding tissue to heat up to temperatures between 50°C and 100°C, which effectively destroys the cells by inducing coagulation necrosis.
The procedure relies on precise control of the heat generated by the radiofrequency energy to target only the abnormal tissue while preserving nearby healthy tissue. The duration and intensity of the energy application are carefully monitored to ensure the right amount of heat is delivered to achieve the desired therapeutic effect.
The heat alters the tissue structure, creating small scars or lesions that prevent problematic signals from passing through (in the case of arrhythmia) or eliminate abnormal growths (such as tumors).
The result is localized destruction of abnormal cells without the need for more invasive and destructive surgery.
How Does Pulsed Field Ablation Work?
PFA is similar to RFA in that concentrated energy is used to destroy unhealthy tissues and is typically done minimally invasively. However, it uses short bursts of high-voltage electrical pulses, not heat generated by radio waves, to selectively target and destroy cells.
PFA targets cells more precisely than RFA as well as destroys cells in a different way. The process, called electroporation, creates microscopic pores in the cell membranes of the targeted tissue. This disruption in the membrane causes the cells to lose their ability to function, leading to cell death.
The procedure begins with the placement of a specialized catheter at the treatment site. Instead of generating heat like in Radiofrequency Ablation, the catheter delivers controlled, high-voltage electric pulses in rapid succession. These pulses affect the cell membrane, creating permeable openings.
The cells can no longer maintain their vital functions due to the loss of membrane integrity and eventually die.
A key reason PFA is gaining momentum over RFA, especially for AFib treatments, is that it does not rely on heat to destroy tissue. This allows for more precise targeting of the affected cells and reduces the risk of damage to surrounding critical structures such as the esophagus.
The electric pulses can be designed to selectively affect certain types of cells, making the process highly specific and reducing the amount of healthy tissue to be unintentionally destroyed in the procedure.
Key Differences Between RFA and PFA
Although both RFA and PFA are effective in ablating targeted tissue, they differ significantly in their methods and impacts on the surrounding tissue.
| Aspect | Radiofrequency Ablation | Pulsed Field Ablation |
| Energy Source | Radiofrequency energy (heat) | High-voltage electrical pulses |
| Mechanism of Action | Destroys tissue by generating heat and causing thermal damage | Disrupts cell membranes through electroporation, causing cell death without heat |
| Tissue Selectivity | Non-selective, can affect both targeted and surrounding tissue due to heat | More selective, primarily affects the targeted cells with minimal impact on surrounding tissue |
| Thermal Effects | Thermal, risk of collateral damage to nearby structures | Non-thermal, reducing the risk of heat-related complications |
| Procedure Time | Generally longer due to the need for careful control of heat application | Shorter, as electric pulses are delivered rapidly and efficiently |
| Safety Profile | Well-established but carries risks of heat-related complications, such as esophageal damage or nerve injury | Emerging with a strong safety profile, lower risk of collateral damage due to non-thermal approach |
| Innovation Status | Established, widely used for decades | Newer technology, still under ongoing research and development in clinical applications |
While the medical community continues to establish which ablation method is best for atrial fibrillation, both RFA and PFA remain viable technologies with unique advantages and potential.
As research progresses, the development of ablation devices tailored to specific needs will play a critical role in expanding the potential applications of each method, ensuring that both continue to serve as effective treatment options for a wide range of conditions.
Innovation Opportunities for RFA and PFA
Beyond cardiac care, numerous opportunities for innovative medical devices exist to harness the potential of PFA and hone existing RFA technology. For instance, combining traditional RF technology with cooling features is making bone tumor ablation possible. Explorations of the potential of PFA treatments are well under way.
However, In order to make any RFA or PFA treatment possible, a high-quality medical device to safely deliver these treatments are essential.
The Role of Medical Device Development in Advancing Ablation Therapies
To realize the full potential of both PFA and RFA treatments, the development of advanced medical devices is critical. These devices must not only deliver energy with precision but also ensure patient safety, ease of use for healthcare providers, and that regulations and compliance requirements are met.
Medical devices developed for ablation processes must always foster innovation in the following areas:
- Precision energy delivery: Devices must accurately target the abnormal tissue while minimizing damage to surrounding healthy tissue. This requires continuous refinement of energy delivery systems, whether thermal (RFA) or electrical (PFA).
- Safety and monitoring: Advanced monitoring systems are essential for real-time feedback during procedures. This can help practitioners adjust energy levels and catheter placement to optimize outcomes and prevent complications.
- User-friendly design: Devices need to be intuitive and adaptable for use in various clinical settings. Improvements in catheter flexibility, control systems, and interface design can make ablation procedures more accessible to a broader range of healthcare providers.
- Market conditions: No medical device can succeed if there isn’t a patient population large enough to cover the cost of its research and development. When building ablation tools, a careful understanding of who will inevitably benefit from the device must be considered.
| Build better ablation processes with Vantage MedTech’s proprietary platforms: |
Advance RFA and PFA Ablation Science with Vantage MedTech
As the field of ablation therapy continues to advance, the possibilities for innovative treatments are expanding rapidly.
At Vantage MedTech, we are proud to be leaders in ablation device development, pioneering cutting-edge technologies that empower healthcare providers to deliver exceptional care.
Our commitment to innovation and collaboration ensures that we stay ahead of the curve, helping researchers and manufacturers bring effective, safe devices to market that expand what’s possible in ablation therapy.
If you’re ready to partner with a trusted leader in medical device development, contact Vantage MedTech today.
Together, we can shape the future of minimally invasive treatments and improve patient outcomes worldwide.
