Phrenic nerve injury after catheter ablation: Should we worry about this complication?

Rong Bai, Dimpi Patel, Luigi Di Biase, Tamer S. Fahmy, Marketa Kozeluhova, Subramanya Prasad, Robert Schweikert, Jennifer Cummings, Walid Saliba, Michelle Andrews-Williams, Sakis Themistoclakis, Aldo Bonso, Antonio Rossillo, Antonio Raviele, Claus Schmitt, Martin Karch, Jorge A.Salerno Uriarte, Patrick Tchou, Mauricio Arruda, Andrea Natale

Research output: Contribution to journalReview articlepeer-review

127 Scopus citations


Introduction: Phrenic nerve injury (PNI) is a complication that can occur with catheter ablation. Methods: Data from 17 patients with PNI following different catheter ablation techniques were reviewed. PNI was defined as decreased motility (transient) or paralysis (persistent) of the hemi-diaphragm on fluoroscopy or chest X-ray. Patient's recovery was monitored. Normalization of chest images and sniff test would be considered as complete clinical recovery. Results: Out of the 17 PNI patients (16 right, 1 left), 13 (11 persistent, 2 transient) occurred after pulmonary veins isolation with or without superior vena cava ablation. Three patients had persistent PNI after sinus node modification and one other patient experienced PNI after epicardial ventricular tachycardia ablation. Ablation was performed with different energy source including radiofrequency, cryothermal, ultrasound and laser. Patient's symptoms varied broadly from asymptomatic to dyspnea, and even to respiratory insufficiency that required temporary mechanical ventilation support. Two patients with transient PNI resolved immediately after the procedure and the other 15 persistent PNI patients resolved within a mean time of 8.3 ± 6.6 months. Conclusions: PNI caused by catheter ablation appears to functionally recover over time regardless of the energy sources used for the procedure.

Original languageEnglish (US)
Pages (from-to)944-948
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Issue number9
StatePublished - Sep 1 2006
Externally publishedYes


  • Atrial fibrillation
  • Catheter ablation
  • Diaphragm
  • Injury
  • Phrenic nerve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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