scholarly journals Postintervention Dyspnea after Radiofrequency Catheter Ablation: Think of a Phrenic Nerve Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Liliana E. Ramos-Villalobos ◽  
Luis Colin Lizalde ◽  
Manlio F. Márquez ◽  
Pedro Iturralde ◽  
Francisco Castillo
Keyword(s):  
Catheter Ablation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Radiofrequency Catheter Ablation ◽  
Rare Complication ◽  
Pulmonary Veins ◽  
Specific Treatment ◽  
Ablation Therapy ◽  
Phrenic Nerve Injury ◽  
The Right

Phrenic nerve injury (PNI) is a rare complication of catheter ablation therapy, most commonly observed in cryoablation of the right side pulmonary veins. We present a case of PNI after radiofrequency catheter ablation that developed acute dyspnea 24 hours after the intervention. Dyspnea is the main symptom of PNI, so the diagnosis should always be suspected if it appears after any type of catheter ablation involving the trajectory of the phrenic nerve. There is no specific treatment for PNI. The only maneuver that has been reported to accelerate the recovery of PNI is early stopping of the ablation therapy.

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 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

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

scholarly journals Compound motor action potentials in transient and persistent phrenic nerve injury - metanalysis.

2021 ◽  
Author(s):  
Marcin Kuniewicz ◽  
Marcin Kowalski ◽  
Anna Rydlewska ◽  
Grzegorz Karkowski ◽  
Nicholas Jackob ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
Action Potentials ◽  
Rare Complication ◽  
Meta Analysis ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
Motor Action ◽  
Nerve Recovery ◽  
Protective Methods ◽  
The Right

Background: The right phrenic nerve is vulnerable to injury (rPNI) during cryoballoon ablation (CBA) isolation of the right pulmonary veins. The complication can be transient or persistent. The reported incidence of rPNI fluctuates from 4.73% to 24.7% depending on changes over time, CBA-generation, and selected protective methods. Methods: Through September 2019, a database search was performed on MEDLINE, EMBASE, and Cochrane Database. In the selected articles, the references were also extensively searched. The study provides a comprehensive meta-analysis of the overall prevalence of rPNI, assesses the transient to persistent PNI-ratio, the outcome of using compound motor action potentials (CMAP), and estimated average time to nerve recovery. Results: From 2008 to 2019, 10,341 records from 48 trials were included. Out of 783 eighty- PNI (7.7%), 589 (5.7%) were transient, and 194 (1.9%) were persistent. CMAP caused a significant reduction in the risk of persistent PNI from 2.3% to 1.1% (p = 0.05; odds ratio [OR] 2.13) in all CBA groups. The mean time to rPNI recovery extended beyond the hospital discharge was significantly shorter in CMAP group at three months on average versus non CMAP at six months (p = 0.012). CMAP (in contrast to non-CMAP procedures) detects PNI earlier from 4 to 16 sec (p < 0.05; I2 = 74.53%) and 3 to 9º (p < 0.05; I2 = 97.24%) earlier. Conclusions: rPNI extending beyond hospitalization is a relatively rare complication. CMAP use causes a significant decrease in the risk of prolonged injury and shortens the time to recovery

scholarly journals A novel steerable Foley balloon catheter for preventing phrenic nerve injury during epicardial catheter ablation

2014 ◽  
Vol 39 (3) ◽  
pp. 259-259 ◽  
Author(s):  
Naoki Yoshida ◽  
Yasuya Inden ◽  
Kyoko Soejima ◽  
Hiromi Goto ◽  
Toyoaki Murohara
Keyword(s):  
Catheter Ablation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Balloon Catheter ◽  
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

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

Phrenic Nerve Injury After Catheter Ablation: Should We Worry About This Complication?

2006 ◽  
Vol 17 (9) ◽  
pp. 944-948 ◽  
Author(s):  
RONG BAI ◽  
DIMPI PATEL ◽  
LUIGI DI BIASE ◽  
TAMER S. FAHMY ◽  
MARKETA KOZELUHOVA ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Nerve Injury ◽  
Phrenic Nerve ◽  
Phrenic Nerve Injury
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