title: Phrenic nerve injury after catheter ablation: should we worry about this complication?
abstract: BACKGROUND
  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 (n = 13), cryothermal (n = 1), ultrasound (n = 2) and laser (n = 1). 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.
authors.affiliation: Department of Cardiology, Section of Cardiac Pacing and Electrophysiology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.forename: Dimpi
authors.initials: D
authors.lastname: Patel
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Tamer S
authors.initials: TS
authors.lastname: Fahmy
authors.forename: Marketa
authors.initials: M
authors.lastname: Kozeluhova
authors.forename: Subramanya
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authors.lastname: Prasad
authors.forename: Robert
authors.initials: R
authors.lastname: Schweikert
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cummings
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.forename: Michelle
authors.initials: M
authors.lastname: Andrews-Williams
authors.forename: Sakis
authors.initials: S
authors.lastname: Themistoclakis
authors.forename: Aldo
authors.initials: A
authors.lastname: Bonso
authors.forename: Antonio
authors.initials: A
authors.lastname: Rossillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Raviele
authors.forename: Claus
authors.initials: C
authors.lastname: Schmitt
authors.forename: Martin
authors.initials: M
authors.lastname: Karch
authors.forename: Jorge A Salerno
authors.initials: JA
authors.lastname: Uriarte
authors.forename: Patrick
authors.initials: P
authors.lastname: Tchou
authors.forename: Mauricio
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authors.lastname: Arruda
authors.forename: Andrea
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authors.lastname: Natale
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010791:Phrenic Nerve / Q000293:injuries*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies