Skip to main content
SpringerLink
Log in

First report of phrenic nerve injury during pulmonary vein isolation using the Ablation Frontiers pulmonary vein ablation catheter

  • CASE REPORT
  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

In an attempt to improve procedural outcomes and reduce time and complications, there has been particular interest in alternative technologies specifically designed for atrial fibrillation (AF) ablation. One novel technique is isolation of the pulmonary veins using an over-the-wire multielectrode catheter delivering duty-cycled bipolar and unipolar radiofrequency energy. Phrenic nerve injury is a rare but significant complication of AF ablation. This is the first report of phrenic nerve injury following catheter ablation for AF using the Pulmonary Vein Ablation Catheter (Medtronic, Minneapolis, MN, USA).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Fisher, J. D., Spinelli, M. A., Mookherjee, D., Krumerman, A. K., & Palma, E. C. (2006). Atrial fibrillation ablation: reaching the mainstream. Pacing and Clinical Electrophysiology, 29, 523–537.

    Article  PubMed  Google Scholar 

  2. Cappato, R., Calkins, H., Chen, S. A., Davies, W., Iesaka, Y., Kalman, J., et al. (2005). Worldwide survey on the methods, efficacy and safety of catheter ablation for human atrial fibrillation. Circulation, 111, 1100–1105.

    Article  PubMed  Google Scholar 

  3. Sanchez-Quintana, D., Cabrera, J. A., Climent, V., Farre, J., Weiglein, A., & Ho, S. Y. (2005). How close are the phrenic nerves to cardiac structures? Implication for cardiac interventionalists. Journal of Cardiovascular Electrophysiology, 16(3), 309–313.

    Article  PubMed  Google Scholar 

  4. Sacher, F., Monahan, K., Thomas, S., Davidson, N., Adragao, P., & Sanders, P. (2006). Phrenic nerve injury after atrial fibrillation catheter ablation. Characterization and outcome in a multicentre study. Journal of the American College of Cardiology, 47, 2498–2503.

    Article  PubMed  Google Scholar 

  5. Lee, B. K., Choi, K. J., Kim, J., Rhee, K. S., Nam, G. B., & Kim, Y. H. (2004). Right phrenic nerve injury following electrical disconnection of the right superior pulmonary vein. Pacing and Clinical Electrophysiology, 27, 1444–1446.

    Article  PubMed  Google Scholar 

  6. Bai, R., Patel, D., Di Biase, L., Fahmy, T. S., Kozeluhova, M., Prasad, S., et al. (2006). Phrenic nerve injury after catheter ablation: should we worry about this complication? Journal of Cardiovascular Electrophysiology, 17, 944–948.

    Article  PubMed  Google Scholar 

  7. Haines, D. E., & Watson, D. D. (1989). Tissue heating during radiofrequency catheter ablation: a thermodynamic model and observations in isolated perfused and superfused canine right ventricular free wall. Pacing and Clinical Electrophysiology, 12, 962–976.

    Article  CAS  PubMed  Google Scholar 

  8. Tsong, T. Y., & Su, Z. D. (1999). Biological effects of electric shock and heat denaturation and oxidation of molecules, membranes and cellular functions. Annals of the New York Academy of Sciences, 888, 211–232.

    Article  CAS  PubMed  Google Scholar 

  9. Holden, A. V., & Biktashev, V. N. (2002). Computational biology of propagation in excitable media: models of cardiac tissue. Chaos Solitons Fractals, 13, 1643–1658.

    Article  Google Scholar 

  10. Bunch, T. J., Bruce, G. K., Mahaptra, S., Johnson, S., Miller, D., Sarabanda, A., et al. (2005). Mechanisms of phrenic nerve injury during radiofrequency ablation at the pulmonary vein orifice. Journal of Cardiovascular Electrophysiology, 16, 1318–1325.

    Article  PubMed  Google Scholar 

  11. Natale, A., Pisano, E., Shewchik, J., Bash, D., Fanelli, R., Potenza, D., et al. (2000). First human experience with pulmonary vein isolation using a through-the-balloon circumferential ultrasound ablation system for recurrent atrial fibrillation. Circulation, 102, 1879–1882.

    CAS  PubMed  Google Scholar 

  12. Su, W. W., Johnson, S. B., & Packer, D. L. (2002). Collateral damage from circumferential laser energy ablation of pulmonary veins. European Heart Journal, 23, 522.

    Google Scholar 

  13. Tse, H. F., Reek, S., Timmermans, C., Lee, K. L., Geller, J. C., Rodriguez, L. M., et al. (2003). Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosis. Journal of the American College of Cardiology, 42, 752–758.

    Article  PubMed  Google Scholar 

  14. Sarabanda, A. V., Bunch, T. J., Johnson, S. B., Mahapatra, S., Milton, M., Leite, L., et al. (2005). Efficacy and safety of circumferential pulmonary vein isolation using a novel cryothermal balloon ablation system. Journal of the American College of Cardiology, 46, 1902–1912.

    Article  PubMed  Google Scholar 

  15. Boersma, L. V., Wijffels, M. C., Oral, H., Wever, E. F., & Morady, F. (2008). Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. Heart Rhythm, 5, 1635–1642.

    Article  PubMed  Google Scholar 

  16. Wijfells, M. C., Oosterhout, M. V., Boersma, L. V., Werneth, R., Kunis, C., Hu, B., et al. (2009). Characterization of in vitro and in vivo lesions made by a novel multichannel ablation generator and a circumlinear decapolar ablation catheter. J Cardiovasc Electrophysiol, 20(10), 1142–1148.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Heart Hospital, University College London, London, UK

    Syed Y. Ahsan, Andrew S. Flett, Pier D. Lambiase & Oliver R. Segal

  2. Department of Cardiovascular Electrophysiology, The Heart Hospital, 16-18 Westmoreland Street, London, W1G 8PH, UK

    Oliver R. Segal

Authors
  1. Syed Y. Ahsan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew S. Flett
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pier D. Lambiase
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Oliver R. Segal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Oliver R. Segal.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(AVI 15,719 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ahsan, S.Y., Flett, A.S., Lambiase, P.D. et al. First report of phrenic nerve injury during pulmonary vein isolation using the Ablation Frontiers pulmonary vein ablation catheter. J Interv Card Electrophysiol 29, 187–190 (2010). https://doi.org/10.1007/s10840-010-9517-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-010-9517-1

Keywords

Search

Navigation