Key result
HPSD catheter ablation causes full-thickness indifferent electrode skin burn in severe obesity.
Why the study?
Although high-power short-duration radiofrequency catheter ablation is effective and safe for atrial fibrillation, rare complications such as skin burns at indifferent electrodes remain poorly characterized.
Case Report (n=1)
This case highlights the rare but severe risk of full-thickness skin burns at indifferent electrode sites during high-power short-duration RF ablation, particularly in obese patients.
Requires vigilance for indifferent electrode burns in obese patients during HPSD ablation; leaves open incidence and mitigation strategies.
Introduction: High-power short-duration (HPSD) radiofrequency (RF) catheter ablation emerged in 2006 and has recently become the primary modality for RF catheter ablation for atrial fibrillation (1,2). Extensive studies have demonstrated its superior efficacy, reduced procedure time, and comparable complication rates when compared to conventional ablation methods (1,2,3,4). Indifferent electrodes are used in RF ablation techniques to disperse heat energy from the body (5,6). Although skin burns at indifferent electrodes are theoretically possible, they remain rare complications of RF catheter ablation.
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Pansuriya et al. (2024) conducted a case report in Persistent atrial fibrillation (n=1). High-power short-duration radiofrequency catheter ablation was evaluated on Skin burn at indifferent electrode site. High-power short-duration radiofrequency catheter ablation was complicated by a full-thickness skin burn at the indifferent electrode site in a morbidly obese patient.
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