Imaging before cryoablation of atrial fibrillation: is phrenic nerve palsy predictable?
Why the study?
Does pre-ablation MDCT measurement of the RUPV ostium to RPA distance predict phrenic nerve palsy during cryoablation for atrial fibrillation?
Population
162 patients undergoing multidetector computerized tomography with 3D reconstruction of the left atrium…
Design
Cohort
Follow-up
Acute procedural
Authors
Discussion
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Member takes
Implication
May support MDCT-based PNP risk stratification before cryoablation; leaves open prospective validation before practice change.
Structured PICO
Does pre-ablation MDCT measurement of the RUPV ostium to RPA distance predict phrenic nerve palsy during cryoablation for atrial fibrillation?
P
Population
162 patients undergoing multidetector computerized tomography (MDCT) with 3D reconstruction of the left atrium prior to cryoablation for atrial fibrillation. The right pericardiophrenic artery was detectable in 145 patients (mean age 54.5 ± 10.1 years, 52.4% male, 80.7% paroxysmal AF).
I
Intervention
Pre-ablation cardiac imaging with 64-slice MDCT to measure the distance from the right upper pulmonary vein (RUPV) ostium to the right pericardiophrenic artery (RPA)
O
Outcome
Occurrence of transient right phrenic nerve palsy (PNP) during cryoablationsafety
Pre-ablation 64-slice MDCT can identify the right pericardiophrenic artery, and its distance to the right upper pulmonary vein ostium is an independent predictor of phrenic nerve palsy during cryoballoon ablation for atrial fibrillation.
Cite This Study
Canpolat et al. (2013) studied this question.