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03-01-2024 | Atrial Fibrillation | Original Paper

Phrenic nerve injury after atrial fibrillation ablation: different recovery courses among cryoballoon, laser balloon, and radiofrequency ablation

Authors: Takatoshi Shigeta, Shinsuke Miyazaki, Yuhei Isonaga, Hirofumi Arai, Naoyuki Miwa, Yosuke Hayashi, Shota Kakehashi, Osamu Inaba, Hitoshi Hachiya, Yasuteru Yamauchi, Junichi Nitta, Hiroshi Tada, Masahiko Goya, Tetsuo Sasano

Published in: Clinical Research in Cardiology | Issue 1/2025

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Abstract

Background

Phrenic nerve injury (PNI) is one of the common complications in atrial fibrillation (AF) ablation, which often recovers spontaneously. However, the course of its recovery has not been examined fully, especially in regard to the different ablation methods. We sought to compare the recovery course of PNI in cryoballoon, laser balloon, and radiofrequency ablation.

Methods

This multicenter retrospective study analyzed 355 patients who suffered from PNI during AF ablation. PNI occurred during cryoballoon ablation (CB group) and laser balloon ablation (LB group) for a pulmonary vein isolation in 288 and 20 patients, and radiofrequency ablation for a superior vena cava (SVC) isolation (RF-SVC group) in 47 patients, respectively

Results

There was a significant difference in the estimated probability of PNI recovery after the procedure between the methods (p = 0.01). PNI recovered significantly earlier in the CB group, especially within 24 h and 3 months post-procedure (the percentage of the recovery within 24 h and 3 months: 49.7% and 71.5% in the CB group, 15.0% and 22.2% in the LB group, and 23.4% and 41.9% in the RF-SVC group, respectively). Persistent PNI after 12 months was observed in only seven patients in the CB group, one in the LB group, and four in the RF-SVC group, respectively.

Conclusion

PNI rarely persists over 12 months after AF ablation; however, there is a difference in the timing of its recovery. PNI recovers quicker with cryoballoon ablation than with laser balloon ablation or radiofrequency ablation of the SVC.

Graphical abstract

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Metadata
Title
Phrenic nerve injury after atrial fibrillation ablation: different recovery courses among cryoballoon, laser balloon, and radiofrequency ablation
Authors
Takatoshi Shigeta
Shinsuke Miyazaki
Yuhei Isonaga
Hirofumi Arai
Naoyuki Miwa
Yosuke Hayashi
Shota Kakehashi
Osamu Inaba
Hitoshi Hachiya
Yasuteru Yamauchi
Junichi Nitta
Hiroshi Tada
Masahiko Goya
Tetsuo Sasano
Publication date
03-01-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 1/2025
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-023-02365-3

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