Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: A comparison between the first- and second-generation balloon.

Rubén Casado Arroyo, Jean-Baptiste Chierchia, G. Conte, M. Levinstein, J. Sieira, M. Rodriguez-Mañero, G. Di Giovanni, G. Baltogiannis, Kristel Wauters, Carlo De Asmundis, Andrea Sarkozy, Pedro Brugada

Onderzoeksoutput: Articlepeer review

124 Citaten (Scopus)

Samenvatting

BACKGROUND:

Phrenic nerve palsy (PNP) is the most frequently observed complication during cryoballoon ablation (CB; Arctic Front, Medtronic, MN) occurring in roughly 7%-9% of the cases. The new second-generation cryoballoon ablation Arctic Front Advance (CB-A) (Arctic Front) has recently been launched in the market.

OBJECTIVE:

To evaluate the incidence of right PNP with the new CB-A in comparison with the first-generation balloon in a series of consecutive patients that underwent pulmonary vein isolation with this modality.

METHODS:

The study was designed as an observational study with a prospective follow-up. In total, 121 consecutive patients were included: 80 patients with the CB (group 1) and 41 with the CB-A (group 2).

RESULTS:

Mean procedural times, fluoroscopic times, and time to pulmonary vein isolation documented by real-time recordings were significantly lower in group 2 (P ? .05). The occurrence of PNP was significantly higher in group 2 (6.25% [5 of 80] in group 1 vs 19.5% [8 of 41] in group 2; P = .033). At 7 months, PNP persisted in 1 (2.5%) patient in the CB-A group.

CONCLUSIONS:

Right PNP seems to occur in a significantly larger number of patients with the second-generation CB-A. However, this complication is reversible in nearly all cases on short-term follow-up. More refined phrenic nerve monitoring during right-sided pulmonary vein ablation and less vigorous wedging maneuvers in the pulmonary vein ostia might significantly reduce the occurrence of this complication.
Originele taal-2English
Pagina's (van-tot)1318-1324
Aantal pagina's7
TijdschriftHeart Rhythm
Volume10
Nummer van het tijdschriftSeptember
StatusPublished - 2013

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