BACKGROUND: Phrenic nerve palsy (PNP) is the most frequently observed complication in the setting of cryoballoon (CB) ablation (Arctic Front, Medtronic Inc., Minneapolis, MN, USA). Although, usually transient, resolving before the end of the procedure, persistent PNP (not resolving before the end of procedure) can occur. Literature on persistent PNP after second generation CB ablation is relatively sparse. METHODS: A total of 316 consecutive patients having undergone large 28-mm CB ablation as index procedure in the Heart Rhythm Management Center, UZ Brussels, Belgium, from January 2009 to December 2013 were retrospectively reviewed for the study. Of these 117 patients were treated with the first generation CB (CB1) and 199 patients with the second generation CB (CB2). RESULTS: PNP occurred in 10% of the total population. Persistent PNP was only observed following CB2 ablation which occurred in 4.5% of the group. At a mean follow-up of 11 months, diaphragmatic contraction in persistent PNP patients resumed in 78% (7/9) of the patients. In a final follow-up at 5 and 20 months, PNP persisted in two patients, respectively. PNP during ablation in the right inferior pulmonary vein was only observed in the CB2 group. No predictors of persistency of PNP were observed. CONCLUSION: Persistence of PNP only occurred in the CB2 group in 4.5% of patients. The majority of patients with persistent PNP were asymptomatic. In most of the patients having persistent PNP after ablation, complete phrenic nerve function resumed during follow-up (78%).
BACKGROUND:Phrenic nerve palsy (PNP) is the most frequently observed complication in the setting of cryoballoon (CB) ablation (Arctic Front, Medtronic Inc., Minneapolis, MN, USA). Although, usually transient, resolving before the end of the procedure, persistent PNP (not resolving before the end of procedure) can occur. Literature on persistent PNP after second generation CB ablation is relatively sparse. METHODS: A total of 316 consecutive patients having undergone large 28-mm CB ablation as index procedure in the Heart Rhythm Management Center, UZ Brussels, Belgium, from January 2009 to December 2013 were retrospectively reviewed for the study. Of these 117 patients were treated with the first generation CB (CB1) and 199 patients with the second generation CB (CB2). RESULTS: PNP occurred in 10% of the total population. Persistent PNP was only observed following CB2 ablation which occurred in 4.5% of the group. At a mean follow-up of 11 months, diaphragmatic contraction in persistent PNP patients resumed in 78% (7/9) of the patients. In a final follow-up at 5 and 20 months, PNP persisted in two patients, respectively. PNP during ablation in the right inferior pulmonary vein was only observed in the CB2 group. No predictors of persistency of PNP were observed. CONCLUSION: Persistence of PNP only occurred in the CB2 group in 4.5% of patients. The majority of patients with persistent PNP were asymptomatic. In most of the patients having persistent PNP after ablation, complete phrenic nerve function resumed during follow-up (78%).
Authors: Federico Cecchini; Giacomo Mugnai; Saverio Iacopino; Juan Pablo Abugattas; Bert Adriaenssens; Maysam Al-Housari; Alexandre Almorad; Gezim Bala; Antonio Bisignani; Carlo de Asmundis; Yves De Greef; Riccardo Maj; Thiago G Osòrio; Luigi Pannone; Bruno Schwagten; Juan Sieira; Antonio Sorgente; Erwin Stroker; Michael Wolf; Gian-Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2022-07-22 Impact factor: 1.759
Authors: Emily N Guhl; Donald Siddoway; Evan Adelstein; Raveen Bazaz; George S Mendenhall; Jan Nemec; Samir Saba; David Schwartzman; Andrew Voigt; Norman C Wang; Sandeep K Jain Journal: J Am Heart Assoc Date: 2016-07-21 Impact factor: 5.501
Authors: Daniel Mol; Lisanne Renskers; Jippe C Balt; Rohit E Bhagwandien; Yuri Blaauw; Vincent J H M van Driel; Antoine H G Driessen; Arif Elvan; Richard Folkeringa; Rutger J Hassink; Bart Hooft van Huysduynen; Justin G L M Luermans; Jeroen Y Stevenhagen; Pepijn H van der Voort; Sjoerd W Westra; Joris R de Groot; Jonas S S G de Jong Journal: J Cardiovasc Electrophysiol Date: 2022-01-28 Impact factor: 2.942