Key result
Phrenic nerve palsy occurred in 5.7% of patients undergoing cryoballoon ablation for atrial fibrillation, with most recovering within one year, though 0.6% had persistent palsy for more than 4 years.
Why the study?
Phrenic nerve palsy from cryoballoon pulmonary vein isolation of atrial fibrillation is mostly transient, but long-term follow-up outcomes had not been reported.
What is the long-term course of phrenic nerve palsy after cryoballoon ablation for atrial fibrillation?
Observational (n=511)
No
What is the long-term course of phrenic nerve palsy after cryoballoon ablation for atrial fibrillation?
Phrenic nerve palsy after cryoballoon ablation for atrial fibrillation is usually transient and recovers within a year, but can persist for over 4 years in a small fraction of patients.
Transient PNP after cryoballoon PVI typically resolves long-term; leaves open predictors and prevention in prospective cohorts.
While phrenic nerve palsy (PNP) due to cryoballoon pulmonary vein isolation (PVI) of atrial fibrillation (AF) was transient in most cases, no studies have reported the results of the long-term follow-up of PNP. This study aimed to summarize details and the results of long-term follow-up of PNP after cryoballoon ablation. A total of 511 consecutive AF patients who underwent cryoballoon ablation was included. During right-side PVI, the diaphragmatic compound motor action potential (CMAP) was reduced in 46 (9.0%) patients and PNP occurred in 29 (5.7%) patients (during right-superior PVI in 20 patients and right-inferior PVI in 9 patients). PNP occurred despite the absence of CMAP reduction in 0.6%. The PV anatomy, freezing parameters and the operator's proficiency were not predictors of PNP. While PNP during RSPVI persisted more than 4 years in 3 (0.6%) patients, all PNP occurred during RIPVI recovered until one year after the ablation. However, there was no significant difference in the recovery duration from PNP between PNP during RSPVI and RIPVI. PNP occurred during cryoballoon ablation in 5.7%. While most patients recovered from PNP within one year after the ablation, PNP during RSPVI persisted more than 4 years in 0.6% of patients.
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Tokuda et al. (2021) conducted an observational in Atrial Fibrillation (n=511). Cryoballoon ablation was evaluated on Incidence of phrenic nerve palsy (PNP). Phrenic nerve palsy occurred in 5.7% of patients undergoing cryoballoon ablation for atrial fibrillation, with most recovering within one year, though 0.6% had persistent palsy for more than 4 years.
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