A phrenic nerve pacing monitor assembly (28) for a cryogenic balloon catheter system (10) used during a cryoablation procedure, which monitors movement of a diaphragm (42) of a patient (12), includes a pacing detector (36) and a safety system (40). The pacing detector (36) directly monitors movement of the diaphragm (42) of the patient (12) to detect when phrenic nerve pacing is occurring. Additionally, the pacing detector (36) generates monitor output based on the movement of the diaphragm (42) of the patient (12). The safety system (40) receives the monitor output and based at least in part on the monitor output selectively provides an alert when movement of the diaphragm (42) of the patient (12) is atypical. The safety system (40) is configured to provide the alert only while at least one of (i) phrenic nerve pacing is occurring, and (ii) cryoablation is occurring.
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