Phrenic Nerve Injury: An Underrecognized and Potentially Preventable Complication of Pulmonary Vein Isolation Using a Wide-Area Circumferential Ablation Approach

摘要

Phrenic Nerve Injury. Introduction: Phrenic nerve injury (PNI) is a well-known, although uncommon, complication of pulmonary vein isolation (PVI) using radiofrequency energy. Currently, there is no consensus about how to avoid or minimize this injury. The purpose of this study was to determine how often the phrenic nerve, as identified using a high-output pacing, lies along the ablation trajectory of a wide-area circumferential lesion set. We also sought to determine if PVI can be achieved without phrenic nerve injury by modifying the ablation lesion set so as to avoid those areas where phrenic nerve capture (PNC) is observed.