2013
DOI: 10.1016/j.hrthm.2013.01.011
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Immediate balloon deflation for prevention of persistent phrenic nerve palsy during pulmonary vein isolation by balloon cryoablation

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Cited by 123 publications
(72 citation statements)
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“…Still, in all of the present patients, full recovery from PNP, between some minutes after cessation of cryoenergy application and up to 1 year after CBA, was observed. Nevertheless, despite different approaches proposed recently on the avoidance of PNP (preprocedural imaging of the RSPV-SVC relationship, avoidance of antral catheter position, close monitoring of temperature and abrupt cessation of energy delivery, 22 immediate balloon deflation 23 and monitoring of the amplitude of the diaphragmatic compound motor action potentials 24 ), the problem of PNP has not been eliminated. 22 Moreover, a significantly higher number of PNP was observed in patients with enlarged LA, with NLA being a predictor of PNP.…”
Section: Discussionmentioning
confidence: 99%
“…Still, in all of the present patients, full recovery from PNP, between some minutes after cessation of cryoenergy application and up to 1 year after CBA, was observed. Nevertheless, despite different approaches proposed recently on the avoidance of PNP (preprocedural imaging of the RSPV-SVC relationship, avoidance of antral catheter position, close monitoring of temperature and abrupt cessation of energy delivery, 22 immediate balloon deflation 23 and monitoring of the amplitude of the diaphragmatic compound motor action potentials 24 ), the problem of PNP has not been eliminated. 22 Moreover, a significantly higher number of PNP was observed in patients with enlarged LA, with NLA being a predictor of PNP.…”
Section: Discussionmentioning
confidence: 99%
“…Active deflation of the CB upon freezing interruption, that is, bypassing automatic deflation at 201C balloon temperature, has been associated with a shorter thawing phase. 20 This technique could possibly have further decreased the incidence of lesions.…”
Section: Study Limitationsmentioning
confidence: 99%
“…Although the safety of this method has not been demonstrated in a large patient cohort, it is noteworthy that no complications were observed in small clinical series and animal studies. 9,10 Whether combining CMAP monitoring and forced deflation is necessary to avoid PNP is unclear and will require dedicated study.…”
Section: Forced Deflation Emergency Maneuvermentioning
confidence: 99%