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Updated: Jun 13, 2026
Thermal Ablation for the Treatment of Abdominal Tumors
Published on: March 7, 2011
Radiofrequency and microwave tumor ablation in patients with implanted cardiac devices: is it safe?
Brendan D Skonieczki1, Catherine Wells, Elliot J Wasser
1Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI 02903, USA. bskonieczki@lifespan.org
Purpose:
To identify malfunction of implanted cardiac devices during or after thermal ablation of tumors in lung, kidney, liver or bone, using radiofrequency (RF) or microwave (MW) energy.
Materials And Methods:
After providing written consent, 19 patients (15 men and 4 women; mean age 78 years) with pacemakers or pacemaker/defibrillators underwent 22 CT image-guided percutaneous RF or MW ablation of a variety of tumors. Before and after each procedure, cardiac devices were interrogated and reprogrammed by a trained cardiac electrophysiology fellow. Possible pacer malfunctions included abnormalities on electrocardiographic (EKG) monitoring and alterations in device settings. Our institutional review board approved this Health Insurance Portability and Accountability Act-compliant study. Informed consent for participation in this retrospective study was deemed unnecessary by our review board.
Results:
During 20 of 22 sessions, no abnormalities were identified in continuous, EKG tracings or pacemaker functions. However, in two sessions significant changes, occurred in pacemaker parameters: inhibition of pacing during RF application in one, session and resetting of mode by RF energy in another session. These changes did not, result in hemodynamic instability of either patient. MW ablation was not associated with, any malfunction. In all 22 sessions, pacemakers were undamaged and successfully reset to original parameters.
Conclusion:
RF or MW ablation of tumors in liver, kidney, bone and lung can be performed safely in patients with permanent intra-cardiac devices, but careful planning between radiology and cardiology is essential to avoid adverse outcomes.
Insights
Radiofrequency (RF) or microwave (MW) ablation for tumors is safe in patients with cardiac devices. Careful planning is essential to prevent potential pacemaker malfunctions during these procedures.
Area of Science:
- Interventional Radiology
- Cardiology
- Oncology
Background:
- Implanted cardiac devices like pacemakers are common in patients requiring tumor ablation.
- Thermal ablation techniques, including radiofrequency (RF) and microwave (MW) energy, are used to treat various tumors.
- Potential interactions between ablation energy and cardiac devices require investigation.
Purpose of the Study:
- To evaluate the safety and identify potential malfunctions of implanted cardiac devices during thermal ablation of tumors.
- To assess device behavior during and after radiofrequency (RF) and microwave (MW) ablation procedures.
Main Methods:
- Nineteen patients with pacemakers or defibrillators underwent 22 CT-guided percutaneous RF or MW tumor ablations.
- Cardiac devices were interrogated and reprogrammed before and after each ablation session.
- Electrocardiographic (EKG) monitoring and device parameter checks were performed to detect malfunctions.
Main Results:
- No abnormalities were detected in 20 out of 22 ablation sessions.
- Two sessions showed temporary pacemaker parameter changes (inhibition, mode resetting) during RF ablation, without hemodynamic compromise.
- Microwave (MW) ablation showed no associated device malfunctions.
- All pacemakers remained undamaged and were successfully reset post-procedure.
Conclusions:
- Radiofrequency (RF) and microwave (MW) ablation for liver, kidney, bone, and lung tumors can be safely performed in patients with permanent intra-cardiac devices.
- Close collaboration between radiology and cardiology is crucial for successful and safe tumor ablation in these patients.
- Careful pre-procedural planning can mitigate risks and prevent adverse outcomes related to cardiac device function.
