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

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.

scholarly journals Predictors of Phrenic Nerve Injury During Pulmonary Vein Isolation for Curing Atrial Fibrillation With Balloon-Based Visually Guided Laser Ablation

2021 ◽  
Vol 85 (3) ◽  
pp. 275-282
Author(s):  
Shinichi Tachibana ◽  
Kaoru Okishige ◽  
Koji Sudo ◽  
Takatoshi Shigeta ◽  
Yuichiro Sagawa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Laser Ablation ◽  
Nerve Injury ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Phrenic Nerve ◽  
Visually Guided ◽  
Phrenic Nerve Injury

scholarly journals Phrenic Nerve Injury After Atrial Fibrillation Catheter Ablation

2006 ◽  
Vol 47 (12) ◽  
pp. 2498-2503 ◽  
Author(s):  
Frédéric Sacher ◽  
Kristi H. Monahan ◽  
Stuart P. Thomas ◽  
Neil Davidson ◽  
Pedro Adragao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Phrenic Nerve Injury

Recordings of diaphragmatic electromyograms during cryoballoon ablation for atrial fibrillation accurately predict phrenic nerve injury

Heart Rhythm ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 369-374 ◽  
Author(s):  
Mayur Lakhani ◽  
Faisul Saiful ◽  
Valay Parikh ◽  
Nikhil Goyal ◽  
Soad Bekheit ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Cryoballoon Ablation ◽  
Phrenic Nerve Injury

Quick, safe, and effective maneuver to prevent phrenic nerve injury during cryoballoon ablation of atrial fibrillation

2018 ◽  
Vol 53 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Kaoru Okishige ◽  
Hideshi Aoyagi ◽  
Takatoshi Shigeta ◽  
Rena A. Nakamura ◽  
Takuro Nishimura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Cryoballoon Ablation ◽  
Phrenic Nerve Injury

Using anatomical landmark to avoid phrenic nerve injury during balloon-based procedures in atrial fibrillation patients

2017 ◽  
Vol 39 (12) ◽  
pp. 1369-1375 ◽  
Author(s):  
Nicolina M. Smith ◽  
Larry Segars ◽  
Travis Kauffman ◽  
Anthony B. Olinger
Keyword(s):  
Atrial Fibrillation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Anatomical Landmark ◽  
Phrenic Nerve Injury
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