To the Editor:—
I read your editorial view on pulsed radiofrequency with great interest. I wish to point out that the narration of the history of pulsed radiofrequency is incorrect.
I remember this period quite clearly. During the meeting in Austria, Professor Sinerik Ayrapetyan, Ph.D., from Yerevan, Armenia, suggested that the clinical effect of radiofrequency could be due to exposure to magnetic fields. In your editorial, it sounds as if this assumption might be right. It is not. The magnetic field at 500,000 Hz is negligible. William Rittman, M.S. (Principal, RF Medical Devices, Middleton, MA), and I did not realize this at that time, but it gave us the idea that the role of heat might be disputable. Mr. Rittman then suggested applying radiofrequency without using a ground lead, thus breaking the circuit. In retrospect, this could only cause a minor biologic effect, but I have tried it. It had an effect in a minority of patients, certainly not enough to follow that road any further.
There was a deadlock then, lasting until approximately 6 months after the Austria meeting. The suggestion that “Mr. Rittman returned to the bench and quickly devised a means …” is therefore fantasy. It was a period of intensive interaction about the subject between Professor Eric Cosman, Ph.D. (then director of Radionics [Burlington, MA]), Mr. Rittman, and myself, but we did not find a workable solution, and no action was taken. Finally, it was my idea to pulse the output of the radiofrequency generator, and it was only then that the deadlock was broken, during the autumn of 1995. An RFG 3C was then adapted to generate the appropriate output. Anecdotally, this museum piece is still in use to treat pain in horses, in a veterinary clinic in Niederlenz, Switzerland. The first clinical application of pulsed radiofrequency was in my practice in Amsterdam, on February 1, 1996.
I read that your information was based on a personal written communication by Mr. Rittman. To put it mildly, I find that an unconventional way to gather information for an editorial in a prestigious journal such as yours. There is nothing against that, provided that the facts are checked. This would have been easy in this case, and it would have prevented you from printing inaccurate information.
Maastricht University, Maastricht, The Netherlands, and Swiss Paraplegic Center, Nottwil, Switzerland. firstname.lastname@example.org