ECG Changes during Radiofrequency Ablation of Liver Metastasis under General Anaesthesia - A Dilemma with Cardiac Event

Abstract

Electrocardiogram (ECG) monitoring is one of the mandatory monitoring during surgery under anaesthesia for identifying any cardiac event like arrthymias or ischemic changes. The operating room is increasingly being studded with various electrical equipments. These electrical gadgets may interfere with the ECG monitoring and thus produce various artifacts mimicking arrthymias or ischemic changes. We report a case of ECG changes induced artifactually by the use of radiofrequency ablation (RFA) for ablating hepatic metastasis under general anaesthesia. Our case emphasizes that awareness of such artifacts in ECG during radiofrequency ablation is required and if it occurs it should be cautiously interperated and managed.

Cervical Radiofrequency Ablation Artifact Mimicking an Electrographic Seizure on RNS

“…Radiofrequency ablation produces heat that conducts electrical currents at a prescribed frequency transmissible through soft tissue including the brain. 12 Given the lack of detection to lumbar RFA, we suggest the electrical current produced by RFA created a near-field artifact that was mistakenly detected by the RNS, subsequently leading to mistreatment. Unlike scalp EEG where movement-induced artifact dominates as a seizure mimic, implantable neurostimulators may be more susceptible to electrical artifacts that can be challenging to resolve without applying the strict principles of localization and polarity.…”