title: Phrenic nerve protection via packing of gauze into the pericardial space during ablation of cristal atrial tachycardia in a child.
abstract: The success of catheter ablation of focal atrial tachycardia is limited by possible collateral damage to the phrenic nerve. Protection of the phrenic nerve is required. Here we present a case of a 9-year-old girl having a history of an unsuccessful catheter ablation of a focal atrial tachycardia near the crista terminalis (because of proximity of the phrenic nerve) who underwent a successful ablation by means of a novel technique for phrenic nerve protection: packing of gauze into the pericardial space. This method is a viable approach for patients with a failed endocardial ablation due to the proximity of the phrenic nerve.
authors.affiliation: Department of Pediatric Cardiology, Okinawa Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Okinawa, 901-1193, Japan. bigkaz@mua.biglobe.ne.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Okinawa Children's Medical Center, Okinawa, Japan.
authors.forename: Tai
authors.initials: T
authors.lastname: Fuchigami
authors.affiliation: Department of Pediatric Cardiology, Okinawa Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Okinawa, 901-1193, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Nabeshima
authors.affiliation: Department of Pediatric Cardiology, Okinawa Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Okinawa, 901-1193, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Sashinami
authors.affiliation: Department of Pediatric Cardiology, Okinawa Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Okinawa, 901-1193, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Nakayashiro
mesh_terms: D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000009:adverse effects; D002648:Child; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D010496:Pericardium; D059348:Peripheral Nerve Injuries / Q000209:etiology / Q000517:prevention & control*; D010791:Phrenic Nerve / Q000293:injuries*; D013526:Surgical Mesh; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Atrial tachycardia; Catheter ablation; Phrenic nerve injury