June 3, 2009Journal of Cardiovascular Electrophysiology
Distortion of Right Superior Pulmonary Vein Anatomy by Balloon Catheters as a Contributor to Phrenic Nerve Injury
Key result
Balloon inflation in the right superior pulmonary vein significantly narrowed the distance to the phrenic nerve from 9.4 mm to 4.8 mm (P<0.001), potentially explaining phrenic nerve injury.
Why the study?
Does balloon inflation in the right superior pulmonary vein distort anatomy and decrease the distance to the phrenic nerve in a canine model?
Population
10 dogs undergoing right thoracotomy for epicardial mapping of the phrenic nerve
Comparison
Balloon inflation in the right superior… vs Pre-inflation anatomy
Design
Preclinical
Authors
Discussion
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Implication
May inform phrenic protection during cryoballoon ablation; leaves open human translation and clinical validation.
Structured PICO
Does balloon inflation in the right superior pulmonary vein distort anatomy and decrease the distance to the phrenic nerve in a canine model?
P
Population
10 dogs undergoing right thoracotomy for epicardial mapping of the phrenic nerve
I
Intervention
Balloon inflation in the right superior pulmonary vein (RSPV)
C
Comparator
Pre-inflation anatomy (original RSPV-to-PN distance)
O
Outcome
Distance between the RSPV/balloon surface and the phrenic nervesurrogate
Main Result
Absolute Event Rate: 4.8% vs 9.4%
p-value: p=< 0.001
Balloon catheter inflation in the RSPV significantly distorts local anatomy, reducing the distance to the phrenic nerve and potentially explaining the mechanism of phrenic nerve injury during AF ablation.
Cite This Study
Okumura et al. (2009) studied Atrial Fibrillation (n=10). Balloon catheter inflation vs. Pre-inflation anatomy was evaluated on Distance from the balloon surface/RSPV to the phrenic nerve (mm) (p=< 0.001). Balloon inflation in the right superior pulmonary vein significantly narrowed the distance to the phrenic nerve from 9.4 mm to 4.8 mm (P<0.001), potentially explaining phrenic nerve injury.