To the Editor— Novel method for earlier detection of phrenic nerve injury during cryoballoon applications for electrical isolation of pulmonary veins in patients with atrial fibrillation

Heart Rhythm ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. e1
Author(s):  
Justin Ghosh ◽  
Theodora Nikolaidou ◽  
Mark A. McGuire
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Pulmonary Veins ◽  
Electrical Isolation ◽  
Phrenic Nerve Injury ◽  
Novel Method

Novel method for earlier detection of phrenic nerve injury during cryoballoon applications for electrical isolation of pulmonary veins in patients with atrial fibrillation

Heart Rhythm ◽  
2016 ◽  
Vol 13 (9) ◽  
pp. 1810-1816 ◽  
Author(s):  
Kaoru Okishige ◽  
Hideshi Aoyagi ◽  
Naohiko Kawaguchi ◽  
Nobutaka Katoh ◽  
Mitsumi Yamashita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Pulmonary Veins ◽  
Electrical Isolation ◽  
Phrenic Nerve Injury ◽  
Novel Method

Abstract 13686: Increased Right Superior Pulmonary Vein Ovality is Associated With Phrenic Nerve Injury in Patients Undergoing Cryoablation for Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Aditi S Vaishnav ◽  
Kristie M Coleman ◽  
Parth Makker ◽  
Moussa Saleh ◽  
Kabir Bhasin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Pulmonary Veins ◽  
Access Site ◽  
Cross Sectional ◽  
Phrenic Nerve Injury ◽  
Diaphragmatic Palsy ◽  
Significant Difference ◽  
Shape Effects

Introduction: Success of cryoablation for atrial fibrillation (AF) requires creation of continuous, circumferential lesions around the pulmonary veins (PVs). The depth of these cryo-lesions depends on tissue contact, balloon location, ablation duration and nadir temperature. An optimum lesion depth must be achieved such that effective isolation occurs without collateral cryothermal damage to surrounding structures eg, phrenic nerve injury (PNI). Hypothesis: Increased RSPV ovality results in poor pairing between the balloon and PV, which may cause deeper freezing at the lateral circumference of the PV antrum, near the course of the phrenic nerve, resulting in PNI. Methods: Consecutive patients undergoing cryoablation for paroxysmal/persistent AF were included. Pre-procedural cardiac CT scans were analyzed to evaluate PV size (diameters, cross-sectional area, circumference) and ovality (ratio of maximum:minimum diameter (d max :d min ), shape). Effects of these anatomic characteristics on rates of complications were analyzed. Results: RSPVs from 310 patients (age 65.2 years, 38.1% female, 43.2% persAF) were studied. RSPVs were the largest of the 4 normal PVs (d max 21.5±4 mm; d min 17.8±3.8 mm; area 309±113 mm 2 ; circumference 124.2±22.8 mm). A majority of RSPVs were round (57.3% round, 26.9% oval and 15.9% flat), with median d max :d min = 1.18 [1.1-1.32]. PNI was the 2nd most common complication (after access-site complications). Transient diaphragmatic palsy occurred in 2.9% of patients; there were no cases of complete or persistent diaphragmatic paralysis. Patients in whom diaphragmatic palsy occurred had more oval veins (median d max :d min 1.35 [1.23-1.5] vs 1.18 [1.1-1.31]; p=0.015). Additionally, there was a significant difference in the proportion of patients with round RSPVs who had diaphragmatic palsy (1.1%) compared to those with oval or flat RSPVs (5.3%) (p=0.029) (Fig). Conclusion: Increased RSPV ovality is associated with phrenic nerve injury.

Left phrenic nerve injury during electrical isolation of left-sided pulmonary veins with the second-generation cryoballoon

2017 ◽  
Vol 40 (12) ◽  
pp. 1426-1431 ◽  
Author(s):  
Kaoru Okishige ◽  
Hideshi Aoyagi ◽  
Takurou Nishimura ◽  
Takatoshi Shigeta ◽  
Takehiko Keida ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Phrenic Nerve ◽  
Second Generation ◽  
Pulmonary Veins ◽  
Electrical Isolation ◽  
Phrenic Nerve Injury

scholarly journals Shorter RSPV cryoapplications result in less phrenic nerve injury and similar 1‐year freedom from atrial fibrillation

2020 ◽  
Vol 43 (10) ◽  
pp. 1173-1179
Author(s):  
Marleen M.D. Molenaar ◽  
Tim Hesselink ◽  
Rachel M.A. ter Bekke ◽  
Marcoen F. Scholten ◽  
Randy Manusama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Phrenic Nerve Injury

scholarly journals Left phrenic nerve injury after cryoballoon ablation of the pulmonary veins

EP Europace ◽  
2012 ◽  
Vol 15 (4) ◽  
pp. 514-514 ◽  
Author(s):  
Jean-Sylvain Hermida ◽  
Sarah Traullé ◽  
Maciej Kubala
Keyword(s):  
Nerve Injury ◽  
Phrenic Nerve ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
Phrenic Nerve Injury

Electrical Isolation of the Superior Vena Cava Using Upstream Phrenic Pacing to Avoid Phrenic Nerve Injury

2012 ◽  
Vol 35 (9) ◽  
pp. 1053-1060 ◽  
Author(s):  
TAKEHIRO KIMURA ◽  
SEIJI TAKATSUKI ◽  
KOTARO FUKUMOTO ◽  
NOBUHIRO NISHIYAMA ◽  
YURIKO SATO ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Superior Vena Cava ◽  
Phrenic Nerve ◽  
Superior Vena ◽  
Vena Cava ◽  
Electrical Isolation ◽  
Phrenic Nerve Injury

scholarly journals A novel method for preventing phrenic nerve injury during catheter ablation

Heart Rhythm ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 95-98 ◽  
Author(s):  
Eric Buch ◽  
Marmar Vaseghi ◽  
David A. Cesario ◽  
Kalyanam Shivkumar
Keyword(s):  
Catheter Ablation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Phrenic Nerve Injury ◽  
Novel Method
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