TY - JOUR
T1 - Phrenic nerve injury after catheter ablation
T2 - Should we worry about this complication?
AU - Bai, Rong
AU - Patel, Dimpi
AU - Di Biase, Luigi
AU - Fahmy, Tamer S.
AU - Kozeluhova, Marketa
AU - Prasad, Subramanya
AU - Schweikert, Robert
AU - Cummings, Jennifer
AU - Saliba, Walid
AU - Andrews-Williams, Michelle
AU - Themistoclakis, Sakis
AU - Bonso, Aldo
AU - Rossillo, Antonio
AU - Raviele, Antonio
AU - Schmitt, Claus
AU - Karch, Martin
AU - Uriarte, Jorge A.Salerno
AU - Tchou, Patrick
AU - Arruda, Mauricio
AU - Natale, Andrea
PY - 2006/9
Y1 - 2006/9
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Catheter ablation
KW - Diaphragm
KW - Injury
KW - Phrenic nerve
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U2 - 10.1111/j.1540-8167.2006.00536.x
DO - 10.1111/j.1540-8167.2006.00536.x
M3 - Review article
C2 - 16800858
AN - SCOPUS:33747283696
SN - 1045-3873
VL - 17
SP - 944
EP - 948
JO - Journal of cardiovascular electrophysiology
JF - Journal of cardiovascular electrophysiology
IS - 9
ER -