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Collateral Nervous Damages After Cryoballoon Pulmonary Vein Isolation.
MedLine Citation:
PMID:  22081875     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Collateral Nervous Damages. Introduction: Various types of complications have been reported after atrial fibrillation (AF) ablation using radiofrequency energy, but those have not been well defined when using cryoballoon ablation technique. The objective of this prospective study was to assess types, incidence, and outcome of complications after cryoballoon pulmonary vein isolation (PVI). Methods and Results: This prospective monocentric study included 66 consecutive patients (39 males, age 57 ± 11 years) who underwent cryoballoon PVI for symptomatic paroxysmal AF. Phrenic nerve (PN) integrity was assessed by pacing from the superior vena cava during isolation of the right PVs. Before discharge, all patients were subjected to 24-hour Holter electrocardiograms, echocardiography, and esophagogastroduodenoscopy. Cardiac MRI was scheduled between 1 and 3 months postprocedure. At 3.7 ± 1.7 months after ablation, patients underwent clinical review and 24-hour Holter electrocardiograms. The mean number of cryoballoon applications was 10.0 ± 2.1 per patient and 2.5 ± 1.0 per vein. A 28 mm cryoballoon was used in 49 patients (74%) and a 23 mm cryoballoon in the remaining 17 patients (26%). Twelve complications (18%) attributing to collateral nervous damage were noticed in 9 patients: asymptomatic gastroparesis was observed in 6 patients (9%), transient PN palsy (PNP) in 5 (8%), and symptomatic inappropriate sinus tachycardia requiring beta-blocker treatment in 1 (1%). Neither cryoballoon-related esophageal ulceration nor PV stenosis was observed. Conclusion: Gastroparesis and PNP could be observed in a significant number of cases after cryoballoon ablation of AF. These complications are likely due to cryo-induced damages to nervous structures surrounding the heart. (J Cardiovasc Electrophysiol, Vol. pp. 1-7).
Authors:
Aurélie Guiot; Arnaud Savouré; Bénédicte Godin; Frédéric Anselme
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-14
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Division of Cardiac Electrophysiology, Rouen University Hospital, Rouen, France.
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