Key result
Skin burns following radiofrequency catheter ablation are a rare but likely under-reported complication, particularly in patients with higher BMI undergoing prolonged procedures.
Electrophysiologists should be mindful of the risk of skin burns at the dispersive pad site during radiofrequency catheter ablation, especially in patients with high BMI, and employ strategies to minimize this risk.
Over the last four decades, radiofrequency catheter ablation (RFA) has revolutionised the field of cardiac electrophysiology. RFA delivers a sinusoidal high-frequency current that traverses from the ablation electrode, through the intervening tissue, to a large dispersive pad placed on the patient’s skin termed the ‘indifferent electrode’.1 Extra-myocardial thermal injury is a rare but recognised complication of RFA, and includes direct injury to structures surrounding the myocardium (such as to a coronary artery or the oesophagus) through resistive and conductive heating, and indirect injury to distant areas (such as skin burns caused by electrical arcing at the site of the dispersive pad).
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Mills et al. (2024) conducted an editorial in Cardiac arrhythmias. Radiofrequency catheter ablation (RFA) was evaluated. Skin burns following radiofrequency catheter ablation are a rare but likely under-reported complication, particularly in patients with higher BMI undergoing prolonged procedures.
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