Purpose: To assess the feasibility of a hybrid ablative technique based on applying electroporation (EP) pulses just before conducting radiofrequency ablation (RFA). The rationale was that the EP-induced reduction in blood perfusion could be sufficient to reduce the thermal sink effect and hence to increase the coagulation volume in comparison to that created exclusively by RFA./nMaterials and methods: Modeling study and in vivo experimental study. A Cool-tip RF applicator was used both for EP and RFA./nResults: Overall, the results did not show any synergy effect from using the hybrid technique. Applying EP pulses prior to RFA did not increase the coagulation zone obtained and the lesions were almost identical. Additional computer simulations provided an explanation for this; the effect of reducing blood perfusion by thermal damage during RFA completely masks the effect of reducing blood perfusion by EP. This is because both thermal damage and EP affect the same zone, i.e. the tissue around the electrode./nConclusions: Our computer modeling and in vivo experimental findings suggest that the combination of EP and RFA with monopolar applicators does not provide an additional benefit over the use of RFA alone.

This work received financial support from the Spanish “Plan Nacional de I+D+I del Ministerio de Ciencia e Innovación” Grants No. TEC2011-27133-C02-01,02 and TEC2010-17285, from the European Commission through the Marie Curie IRG grant TAMIVIVE (256376) and from the Universitat Politècnica de València (INNOVA11-01-5502; and PAID-06-11 Ref. 1988). The linguistic revision of this paper was funded by the Universitat Politècnica de València, Spain.