Analysis of risk factors for complications in echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation.

BACKGROUND: The feasibility of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM) has been previously reported. However, limited investigation has been conducted regarding the complications associated with this procedure. OBJECTIVE: This study aims to analyze the risk factors affecting the occurrence of complications during PIMSRA, such as pericardial effusion, ventricular premature beats, and interventricular septal perforation. In this study, the optimal cut-off values for these risk factors are also explored, and corresponding strategies for prevention are proposed. METHODS: A total of 101 patients diagnosed with HOCM who underwent the PIMSRA procedure from 2021 to 2022 were included in this retrospective analysis. Patients were classified into subgroups with or without complications based on procedural records. Univariate and multivariate regression analyses were conducted to identify independent risk factors for complications during the PIMSRA procedure. RESULTS: There were 48 patients with complications and 53 patients without complications. The heart rate at the start of the procedure and the maximum left ventricular outflow tract gradient (LVOTG) were independent risk factors related to PIMSRA complications. The optimal cut-off values for predicting complication occurrence were a heart rate > 49 bpm at the start of the procedure (OR: 3.79, 95% CI: 1.64-8.78, p = 0.002) and a maximum LVOTG > 92 mmHg (OR: 2.57, 95% CI: 1.15-5.75, p = 0.022), respectively. CONCLUSIONS: The occurrence of PIMSRA complications is primarily associated with the heart rate at the start of the procedure and the maximum LVOTG. It is recommended to establish a comprehensive control plan to minimize the risk of complications during PIMSRA procedures.

oHSV2-mGM repolarizes TAMs and cooperates with αPD1 to reprogram the immune microenvironment of residual cancer after radiofrequency ablation.

BACKGROUND: Due to the size and location of the tumor, incomplete radiofrequency ablation (iRFA) of the target tumor inhibits tumor immunity. In this study, a murine herpes simplex virus (oHSV2-mGM) armed with granulocyte-macrophage colony-stimulating factor (GM-CSF) was constructed to explore its effect on innate and adaptive immunity during iRFA, and the inhibitory effect of programmed cell death-1 (PD1) on tumor. METHODS: We verified the polarization and activation of RAW264.7 cells mediated by oHSV2-mGM in vitro. Subsequently, we evaluated the efficacy of oHSV2-mGM alone and in combination with αPD1 in the treatment of residual tumors after iRFA in two mouse models. RNA-seq was used to characterize the changes of tumor microenvironment. RESULTS: oHSV2-mGM lysate effectively stimulated RAW264.7 cells to polarize into M1 cells and activated M1 phenotypic function. In the macrophage clearance experiment, oHSV2-mGM activated the immune response of tumor in mice. The results in vivo showed that oHSV2-mGM showed better anti-tumor effect in several mouse tumor models. Finally, oHSV2-mGM combined with PD1 antibody can further enhance the anti-tumor effect of oHSV2-mGM and improve the complete remission rate of tumor in mice. CONCLUSION: The application of oHSV2-mGM leads to the profound remodeling of the immune microenvironment of residual tumors. oHSV2-mGM also works in synergy with PD1 antibody to achieve complete remission of tumors that do not respond well to monotherapy at immune checkpoints. Our results support the feasibility of recombinant oncolytic virus in the treatment of residual tumors after iRFA, and propose a new strategy for oncolytic virus treatment of tumors.

Local Treatment of Desmoid Tumors: An Update.

Desmoid tumors (DTs) are rare fibroblastic proliferations, characterized by infiltrative growth and a propensity for local recurrence. Traditional strategies such as surgery, radiotherapy, and chemotherapy are the mainstays of treatment, each with its limitations and associated risks. The trend in DT management leans toward a "wait-and-see" strategy, emphasizing active surveillance supported by continuous MRI monitoring. This approach acknowledges the unpredictable nature of the disease, and a multidisciplinary management of DT requires a nuanced approach, integrating traditional therapies with emerging interventional techniques. This review highlights the emerging role of minimally invasive interventional radiological technologies and discusses interventional radiology techniques, including chemical, radiofrequency, microwave, cryoablation, and high-intensity focused ultrasound ablations as well as transarterial embolization.

Percutaneous Vertebral Augmentation and Thermal Ablation in Patients with Spinal Metastases.

Vertebral augmentation and thermal ablation offer radiologists a robust minimally invasive option for treatment of patients with spinal metastases. Such interventions are commonly combined and have proved safe and effective in the management of selected patients with vertebral metastases with durable treatment effects. Special attention to procedure techniques including choice of vertebral augmentation technique, choice of ablation modality, and thermal protection is essential for improved patient outcomes. This article provides a review of the most recent advances in vertebral augmentation and thermal ablation for the treatment of spinal metastases.

Pulsed-field ablation versus thermal ablation for atrial fibrillation: A meta-analysis.

Background: Pulsed-field ablation (PFA) is an alternative to thermal ablation (TA) in patients with atrial fibrillation (AF) receiving catheter-based therapy for pulmonary vein isolation (PVI). However, its efficacy and safety have yet to be fully elucidated. Objective: The purpose of this study was to compare the acute and long-term efficacies and safety of PFA and TA. Methods: We performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials comparing PFA and TA in patients with AF undergoing their first PVI ablation. The TA group was divided into cryoballoon (CB) and radiofrequency subgroups. AF patients were divided into paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (PersAF) subgroups for further analysis. Results: Eighteen studies involving 4998 patients (35.2% PFA) were included. Overall, PFA was associated with a shorter procedure time (mean difference [MD] -21.68; 95% confidence interval [CI] -32.81 to -10.54) but longer fluoroscopy time (MD 4.53; 95% CI 2.18-6.88) than TA. Regarding safety, lower (peri-)esophageal injury rates (odds ratio [OR] 0.17; 95% CI 0.06-0.46) and higher tamponade rates (OR 2.98; 95% CI 1.27-7.00) were observed after PFA. In efficacy assessment, PFA was associated with a better first-pass isolation rate (OR 6.82; 95% CI 1.37-34.01) and a lower treatment failure rate (OR 0.83; 95% CI 0.70-0.98). Subgroup analysis showed no differences in PersAF and PAF. CB was related to higher (peri)esophageal injury, and lower PVI acute success and procedural time. Conclusion: Compared to TA, PFA showed better results with regard to acute and long-term efficacy but significant differences in safety, with lower (peri)esophageal injury rates but higher tamponade rates in procedural data.

Mechanisms of action behind the protective effects of proactive esophageal cooling during radiofrequency catheter ablation in the left atrium.

Proactive esophageal cooling for the purpose of reducing the likelihood of ablation-related esophageal injury resulting from radiofrequency (RF) cardiac ablation procedures is increasingly being used and has been Food and Drug Administration cleared as a protective strategy during left atrial RF ablation for the treatment of atrial fibrillation. In this review, we examine the evidence supporting the use of proactive esophageal cooling and the potential mechanisms of action that reduce the likelihood of atrioesophageal fistula (AEF) formation. Although the pathophysiology behind AEF formation after thermal injury from RF ablation is not well studied, a robust literature on fistula formation in other conditions (eg, Crohn disease, cancer, and trauma) exists and the relationship to AEF formation is investigated in this review. Likewise, we examine the abundant data in the surgical literature on burn and thermal injury progression as well as the acute and chronic mitigating effects of cooling. We discuss the relationship of these data and maladaptive healing mechanisms to the well-recognized postablation pathophysiological effects after RF ablation. Finally, we review additional important considerations such as patient selection, clinical workflow, and implementation strategies for proactive esophageal cooling.

DDS-SIRC Cooperative Conferences Feel the Burn: RFA for Chronic Radiation Proctitis.

Chronic radiation proctitis, although relatively rare, can be the source of severe comorbidity in patients who had undergone prior radiotherapy for pelvic malignancy. Although current treatments for radiation proctitis include argon plasma coagulation, heater probe, bipolar neodymium/yttrium aluminum garnet (Nd: YAG) lasers, these interventions are often burdened by the frequent occurrence of rectal ulcerations and stenosis. Since radiofrequency ablation (RFA) is frequently used to ablate esophageal malignancy and pre-malignancy, we report the efficacy of RFA using through the scope system in two patients with rectal bleeding due to radiation proctitis. In both cases, the procedure was well-tolerated with hemostasis achieved after 1 or 2 sessions of RFA. Mucosal re-epithelialization was observed in areas of previous bleeding with no stenosis or ulceration observed at follow-up.

Long-term outcomes of radiofrequency ablation for intrathoracic goiter up to 5 years: evaluated by computed tomography/magnetic resonance imaging and ultrasound.

OBJECTIVES: This study evaluated the long-term efficacy and safety of radiofrequency ablation (RFA) for intrathoracic goiter (ITG) over a follow-up period exceeding six months. METHODS: From 2017 to 2022, 22 patients (6 males, 16 females) with 24 ITGs treated with RFA at a single medical center were evaluated. All patients underwent ultrasonography (US), computed tomography (CT), or magnetic resonance imaging (MRI) before RFA. Follow-up CT/MRI was performed six months after the initial RFA and then every 6-12 months. The primary outcomes measured were the degree of extension, goiter volume, volume reduction rate (VRR), tracheal deviation, and tracheal lumen. Additionally, we assessed the outcomes of single-session RFA (n = 16) vs. multiple sessions (n = 8) on goiters and explored the correlation between ITG volume measurements obtained using ultrasonography and CT/MRI. RESULTS: The median follow-up period was 12 months (interquartile range: 6-36.8 months). At the last follow-up, the nodule volume measured by CT/MRI had significantly decreased (76.2 vs. 24.6 mL; p < 0.05), with a VRR of 64.6%. Patients who underwent multiple RFA sessions showed a significantly higher VRR than the single-session patients (63.8 vs. 80.1%, p < 0.05). The intraclass correlation between goiter volumes measured using US and CT/MRI was moderate. CONCLUSION: This study affirms the long-term efficacy and safety of RFA for ITG, providing an alternative treatment for nonsurgical candidates. Multiple RFA sessions may be beneficial for achieving better volume reduction. Sole reliance on ultrasonography is inadequate; therefore, integrating CT/MRI is essential for accurate pre-RFA and follow-up assessments.

Intrathoracic goiters significantly impact both cosmetic appearance and induce numerous compressive symptoms.Radiofrequency ablation brought notable volume reduction and persistent, effective alleviation of compressive symptoms.Radiofrequency ablation presents a promising therapeutic modality with long-term benefits for patients with intrathoracic goiter.

Radiofrequency ablation in patients with obstructive hypertrophic cardiomyopathy: An updated comprehensive review and meta-analysis.

BACKGROUND: Radiofrequency catheter ablation (RFCA) has emerged as a therapeutic option for surgical myectomy and alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM), but its efficacy remains unclear. AIM: Due to limited research on RFCA for HCM, there is an ongoing attempt to assess its efficacy and safety. METHODS: PubMed, Embase, and Scopus were systematically searched for studies assessing the efficacy outcomes for patients with HOCM who underwent RFCA. Mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random-effects model and heterogeneity was assessed using I2 statistics. RESULTS: We included 11 studies comprising 470 patients, of whom 34.6% were female. The mean patient age ranged from 43.7 to 60.7 years. During the follow-up after RFCA, there was a significant decrease in the left ventricular outflow tract (LVOT) gradient at rest (MD -60.25 mmHg; 95% CI [-70.53;-59.14 mmHg]; p < 0.01) and during stimulation (MD -83.56 mmHg; 95% CI [-100.36;-66.76 mmHg]; p < 0.01). Moreover, RFCA reduced interventricular septum (IVS) thickness (MD -3.61 mm; 95% CI [-5.64; -1.59 mm]; p = 0.01) and New York Heart Association (NYHA) class (MD -1.46; 95% CI [-1.69; -1.24]; p < 0.01). CONCLUSIONS: In patients with HOCM, RFCA was associated with an improved NYHA class, reduced IVS thickness, and decreased LVOT gradient at rest and with stimulation.

Advances in clinical research on ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma.

Ultrasound-guided radiofrequency ablation (RFA) emerges as a minimally invasive strategy for papillary thyroid microcarcinoma (PTMC), offering advantages over traditional surgical approaches. RFA employs high-frequency electric currents under precise ultrasound guidance to ablate cancerous tissue. Clinical trials consistently demonstrate RFA's efficacy in tumor control and patient-reported outcomes. However, long-term studies are essential to validate its durability and monitor for potential complications. Collaborative efforts among various medical disciplines ensure procedural accuracy and comprehensive postoperative care. Technological innovations, such as enhanced ultrasound imaging and temperature control, promise to refine RFA's precision and effectiveness. Nevertheless, challenges persist, including the need for standardized protocols and comparative studies with traditional treatments. Future research should focus on long-term outcomes, patient selection criteria, and optimization of procedural techniques to solidify RFA's role in PTMC management. RFA presents a promising avenue for PTMC treatment, warranting further investigation and refinement in clinical practice.

Radiofrequency Ablation, Cryotherapy Ablation, or Pulsed-Field Ablation to Treat Paroxysmal Atrial Fibrillation Unresponsive to Pharmacological Treatments: Interpreting Efficacy Through Reconstruction of Individual Patient Data From Randomized Trials.

Three techniques of catheter ablation (CA; radiofrequency, cryoballoon, and pulsed-field ablation) are available to treat patients with paroxysmal atrial fibrillation (PAF) who do not adequately respond to pharmacological treatments. Our study was aimed at comparing these techniques based on the data of randomized studies because these are considered the best sources of efficacy data. After selecting pertinent trials, our analysis studied the time-to-event data published for these three techniques. An artificial intelligence method was used that reconstructs individual patient data from the Kaplan-Meier curves. The endpoint was an arrhythmia recurrence. A preliminary heterogeneity analysis was performed. Then, our main analysis was based on individual patient data reconstructed from Kaplan-Meier graphs. The hazard ratio (HR) was its main parameter. Three randomized trials were included. Our heterogeneity analysis confirmed an acceptable level of between-trial heterogeneity that allowed us to pool the curves from the different trials; however, cryoballoon ablation with a two-minute duration fared worse than the other techniques. Then, our main analysis estimated the following values of HR: pulsed-field ablation versus radiofrequency ablation, 0.549 (95%CI, 0.413-0.730; p<0.001); pulsed-field ablation versus cryoballoon ablation, 0.478 (95%CI, 0.364-0.633); radiofrequency ablation versus cryoballoon ablation, HR=0.871 (95%CI, 0.585-1.295; p=0.506). In conclusion, radiofrequency ablation and cryoballoon ablation showed similar effectiveness (except for the two-minute cryoballoon ablation, which fared worse). Our results showing the superiority of pulsed-field ablation versus thermal ablation must be interpreted with caution because the patients given pulsed-field ablation were limited, and their follow-up was shorter than that of patients receiving thermal ablation.

Advances in radiofrequency ablation: mechanism of action and technology.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality that utilizes highfrequency alternating current to destroy targeted tissues through thermal ablation. This manuscript provides an overview of the advancements in RFA, focusing on its mechanism of action and technological innovations. RFA technology was first introduced in the early 1900's, and its use has expanded and evolved, especially in its current utility in the treatment of painful conditions. As the technology has evolved, new techniques, applications and modalities have expanded its use and improved its efficacy. RFA works by applying radiofrequency energy through specialized electrodes, leading to resistive heating and coagulation necrosis. Its advantages include precise tissue targeting, minimal invasiveness, reduced complications, and faster recovery compared to traditional surgical interventions. Technological advancements in RFA have led to improved treatment outcomes. Multi-electrode systems allow for larger ablation zones. Image-guided RFA improves treatment planning and minimizes damage to healthy tissues. Cooled-tip and perfusion electrodes address limitations such as heat sink effects, enhancing RFA's efficacy in challenging anatomical regions. These developments have expanded RFA's applications to liver tumors, lung tumors, renal tumors, cardiac arrhythmias, and chronic pain syndromes. In conclusion, RFA has emerged as a safe and effective thermal ablation technique. Understanding its mechanism of action and integrating advanced technologies have significantly enhanced treatment outcomes. Continued research and innovation in RFA hold immense potential for further improving patient care and outcomes.

Comparative efficacy and safety of radiofrequency ablation and microwave ablation in benign thyroid nodule treatment: a systematic review and meta-analysis.

OBJECTIVE: Ultrasound-guided thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), has become one of the main options for treating benign thyroid nodules (BTNs). To assess the efficacy of thermal ablation of BTNs, we performed a systematic review and meta-analysis of relevant studies. MATERIALS AND METHODS: A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was performed up to September 25, 2023, to identify studies directly comparing RFA and MWA for pathologically proven BTNs and reporting clinical outcomes and complications. Data extraction and quality assessment were independently performed by two radiologists according to PRISMA guidelines. The analysis yielded the serial volume reduction ratios (VRRs) of ablated nodules for up to 12 months, symptom and cosmetic scores, and complications. RESULTS: This analysis included nine studies with 1305 BTNs treated by RFA and 1276 by MWA. VRRs at 1 month, 3 months, and 6 months were similar between RFA and MWA, but RFA showed a significantly higher VRR (83.3%) than MWA (76.9%) at 12 months (p = 0.02). Complication rates showed no significant difference between the two methods. Symptom and cosmetic scores significantly decreased after ablation, without a significant difference between the methods. Subgroup analysis indicated a significantly higher VRR at 12 months for RFA than for MWA for less experienced investigators (≤ 10 years), but no significant difference for more experienced investigators (> 10 years). CONCLUSION: RFA and MWA are both effective and safe methods for treating BTNs. RFA showed a higher VRR at 12 months and seems more suitable for less experienced investigators. CLINICAL RELEVANCE STATEMENT: RFA and MWA are both effective and safe treatments for BTNs, with RFA showing a higher VRR at 12 months. Both methods offer minimally invasive and reliable treatment for thyroid nodules. KEY POINTS: The most effective thermal ablation technique for BTNs remains undetermined. RFA showed a higher VRR at 12 months than MWA. Both techniques are effective for treating thyroid nodules; RFA offers greater benefits, particularly for less experienced investigators.

Percutaneous endocardial septal radiofrequency ablation on syncope in patients with hypertrophic obstructive cardiomyopathy: a short-term safety and efficacy study.

Background: Syncope is a serious consequence in patients with hypertrophic obstructive cardiomyopathy (HOCM). Percutaneous endocardial septal radiofrequency ablation (PESA) has emerged as a promising intervention to alleviate symptoms and enhance the quality of life for HOCM patients. However, little is known about the effects of PESA on syncope in HOCM. The authors aimed to study the effects of PESA on syncope in patients with HOCM. Materials and methods: Nineteen patients with HOCM and syncope were enrolled. The left ventricular outflow tract gradient (LVOTG) of the patients was more than 50 mmHg despite medication. The participants underwent PESA under the guidance of intracardiac echocardiography (ICE) combined with a three-dimensional electrophysiological mapping system. The patients were followed for 3 (3-5.5) months. Results: The mean age of the patients was 54.8±13.7 years. Out of the 19 participants, 7 (37%) were females. During the follow-up, the syncope was completely alleviated in 14 patients (73.7%) or the syncope episodes were reduced greater than or equal to 80% in 16 patients (84.2%). The mean NYHA functional class significantly improved from 2.2±0.7 at baseline to 1.7±0.6 during follow-up (P=0.002). The LVOTG and septal thickness showed a decreasing trend from baseline to follow-up (LVOTG: P=0.083, septal thickness: P=0.086). Conclusion: The authors' investigation provides evidence supporting the effectiveness of PESA in reducing syncope episodes in patients with HOCM.

Relationship between sodium-glucose cotransporter 2 inhibitors and atrial fibrillation recurrence after pulmonary vein isolation in patients with type 2 diabetes and persistent atrial fibrillation.

BACKGROUND: The impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on the postoperative recurrence of atrial fibrillation (AF) in patients with persistent AF undergoing an initial radiofrequency ablation is not yet established. The objective of this study is to assess the impact of SGLT2 inhibitors on the recurrence of AF after radiofrequency ablation in patients with type 2 diabetes complicated persistent AF. METHODS: A total of 182 patients with type 2 diabetes and persistent AF, who underwent their first radiofrequency ablation for AF at our center, were enrolled and divided into two groups: the SGLT2 inhibitor group and the non-SGLT2 inhibitor group. The main outcome of the follow-up was the postoperative recurrence of AF. RESULTS: A total of 49 participants experienced AF recurrence. The use of SGLT2 inhibitors in patients with type 2 diabetes who underwent AF ablation was associated with a significantly lower risk of AF recurrence (adjusted hazard ratio: 0.65; 95% confidence interval: 0.28-0.83; p < .01). CONCLUSIONS: The use of SGLT2 inhibitors is associated with a decreased risk of arrhythmia recurrence after AF ablation in patients with type 2 diabetes complicated with persistent AF.

Local impedance drop-guided versus lesion size index-guided pulmonary vein isolation.

BACKGROUND: Local tissue impedance drop (LID) and lesion size index (LSI) technologies are valuable for predicting effective lesion formation. This study compares the acute and long-term efficacy of LID-guided versus LSI-guided pulmonary vein isolation (PVI) for atrial fibrillation treatment. METHODS: We retrospectively analyzed two patient groups undergoing radiofrequency PVI. In the LID-guided group (n = 35), ablation was performed without contact force monitoring, stopping at the LID plateau (target LID 12 Ohm posterior, 16 Ohm anterior). In the LSI-guided group (n = 31), ablation used contact force information with target LSI (5 anterior, 4 posterior). Both groups utilized a power of 40 W anterior and 30 W posterior, with < 6 mm inter-lesion distance. Gap mapping and touch-up ablation were done if necessary. RESULTS: PVI was achieved with a significantly shorter ablation time in the LSI-guided group (25 min [21;31] vs 30 [27;35], p = 0.035). PV gaps were more frequent in the LID-guided group (74% vs 42%, p = 0.016). Over 11.5 ± 2.9 months follow-up, arrhythmia recurrence was higher in the LID-guided group (34.3% vs 16.1%, p = 0.037). A redo procedure performed in 10 (28.6%) patients in the LID-guided group and 3 (9.7%) in the LSI-guided group showed chronic PV reconnections in 7 out of 10 (70%) and 2 out of 3 (67%) patients, respectively. CONCLUSIONS: LSI-guided ablation results in shorter ablation time and fewer PV gaps compared to LID-guided ablation. Despite initial success, LID-guided ablation had higher arrhythmia recurrence and PV reconnections during long-term follow-up compared to LSI-guided ablation.

Stereo electroencephalography-guided radiofrequency ablation in focal epilepsia partialis continua: illustrative case.

BACKGROUND: Epilepsia partialis continua (EPC) is a variant of focal motor status epilepticus that can occur as a single or repetitive episode with progressive or nonprogressive characteristics. OBSERVATIONS: The authors describe the feasibility of identifying focal EPC in a 33-year-old woman using video electroencephalography (VEEG), electroencephalography source localization, [18F]fluorodeoxyglucose positron emission tomography, magnetic resonance imaging, and psychiatric and neuropsychological assessments and of treating it with stereo electroencephalography-guided radiofrequency (SEEG-RF) ablation. EPC comprised recurrent myoclonus of the right thigh and iliopsoas with a progressive pain syndrome after left anterior-temporo-mesial resection. Switching between VEEG under regular and epidural block helped to define myoclonus as the presenting ictal symptom with a suspected seizure onset zone in the left parietal paramedian lobule. After the epileptic network was identified, SEEG-RF ablation abolished all seizures. No correlation was found between pain and VEEG/SEEG abnormalities. Rehabilitation began 3 days after the SEEG-RF ablation. By 1 year of follow-up, the patient had no EPC and could walk with assistance in rehabilitation; however, due to the abrupt abolishment of EPC and underlying psychological factors, the patient perceived her pain as overriding, which prevented her from walking. LESSONS: The application of SEEG-RF ablation is an efficient therapeutic option for focal EPC with special concerns regarding concurrent nonepileptic pain. https://thejns.org/doi/10.3171/CASE23611.

Radiofrequency ablation for shoulder pain: an updated systematic review.

BACKGROUND: Radiofrequency ablation (RFA) is a treatment modality that has been increasingly used for the management of chronic shoulder pain. Serious conditions that can identified as the cause of chronic shoulder pain include rotator cuff disorders, adhesive capsulitis, osteoarthritis, glenohumeral instability, and acromioclavicular joint disorders. Treatment of chronic shoulder pain typically consists of physical therapy, oral and topical medications, intra-articular corticosteroid injections, and even surgery. The aim of this study was to examine the most recent primary and secondary outcomes of RFA for chronic shoulder pain. METHODS: A systematic review was conducted using three different databases including PubMed, MEDLINE, and the Cochrane Database. The key concepts of "radiofrequency ablation" and "shoulder pain" were used. The search took place in June 2023, and it included articles from the past 20 years. RESULTS: Of the 396 articles found, 29 were included in the review. Most studies focused on reduction in pain scores, duration of relief, function, and patient satisfaction. In several studies, RFA was compared to conservative options such as physical therapy or corticosteroid injections. CONCLUSIONS: Overall, RFA shows positive outcomes in terms of the management of chronic shoulder pain. Therefore, RFA can serve as another treatment option for patients who fail conservative management or are not strong surgical candidates. Understanding the outcomes of RFA for chronic shoulder pain can provide patients and clinicians with evidence for the most appropriate treatment.