Prospective Evaluation of Bilateral Diaphragmatic Electromyograms During Cryoballoon Ablation of Atrial Fibrillation

• DOI: 10.1111/jce.12671
• Publication Date: 2015-03-24T22:09:07Z
• Authors: SHINSUKE MIYAZAKI; HITOSHI HACHIYA; HIROSHI TANIGUCHI; HIROAKI NAKAMURA; NOBORU ICHIHARA; EISUKE USUI; AKIO KUROI; TAKAMITSU TAKAGI; JIN IWASAWA; KENZO HIRAO; YOSHITO IESAKA
• Keywords: Cryoablation; Phrenic nerve

Bilateral Diaphragmatic CMAPs During Cryoablation Background Left phrenic nerve injury (PNI) can occur during cryoballoon ablation of the left pulmonary veins (PVs). This study aimed to evaluate feasibility monitoring bilateral function atrial fibrillation (AF). Methods Fifty consecutive paroxysmal AF patients undergoing using one 28‐mm second‐generation balloon were prospectively enrolled. diaphragmatic compound motor action potentials (CMAPs) obtained from modified surface electrodes by pacing subclavian veins, and monitored 3‐minute applications at ipsilateral PVs. Results One hundred ninety 202 PVs successfully isolated exclusively cryoballoons. could be in all except 3 cases with catheter inaccessibility vein. The right CMAP amplitudes similar baseline (1.04 ± 0.41 mV vs. 1.01 0.43 mV, P = 0.49). Among 105 132 PV while CMAPs, 2 (1.9%) 13 (9.8%) interrupted for a decreased amplitude (P 0.01). them, due PNI 4 applications/patients dislodgement remaining applications. remained 1 recovered day after procedure. Applications without requiring interruptions exhibited no significant changes throughout applications, time‐course pattern was between 0.292). Conclusions A stable similarly vast majority patients. Monitoring might useful anticipate not only but also ablation.