Radiofrequency ablation of the medial branch in the presence of other devices

Radiofrequency ablation (RFA) is a procedure which utilizes electric current to create heat within a tissue and provide a targeted lesion. It involves the image-guided insertion of a needle, which will deliver electric current to the target area. The tip of the needle increases in temperature and will produce a lesion in the target tissue. Many patients requiring RFA as a treatment for chronic pain will have additional implanted devices in their body, such as cardiac implantable electronic devices, deep brain stimulators, spinal cord stimulators, peripheral nerve stimulators, spinal hardware, vagal nerve stimulators, gastric pacers, intrathecal pumps, and more. These devices have the potential to interact with the electromagnetic current from a radiofrequency (RF) probe, which may potentially adversely affect the device or the patient. This chapter considers the effects of RFA in the presence of implantable devices and the guidelines associated with safe utilization of the therapy in these patients.