Left phrenic nerve paresis complicating catheter radiofrequency ablation for Wolff-Parkinson-White syndrome

Rumbak, Mark J.; Chokshi, Saurabh K.; Abel, Naomi; Abel, Warren; Kittusamy, Prem K.; McCormack, Jorge; Patel, Manish; Fontanet, Hector L.

doi:10.1016/s0002-8703(96)90477-9

Cited by 39 publications

(32 citation statements)

References 5 publications

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“…21 However, severe complications, such as damage to the coronary arteries and the phrenic nerve, were described soon after the introduction of epicardial radiofrequency ablation. 22,23 Since then, many techniques have been introduced with varying success to prevent severe complications, such as coronary angiography, 21 endocardial ablation with an ablation catheter equipped with a retractable needle, 24 endocardial ablation to reduce or obviate epicardial ablation, 25 and injection of air or saline into the pericardium. 26 Recently, Wittkampf et al 14 and du Pré et al 15 have demonstrated that epicardial ablation using electroporation in pigs is feasible, safe, and causes only minimal damage to the coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Lesion Size After Epicardial Electroporation Catheter Ablation After Subxiphoid Puncture

Neven

Driel

Wessel

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Section: Discussionmentioning

confidence: 99%

Myocardial Lesion Size After Epicardial Electroporation Catheter Ablation After Subxiphoid Puncture

Neven

Driel

Wessel

et al. 2014

Circ: Arrhythmia and Electrophysiology

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“…Specific to the purpose of this study, there have been reports of PN injury following radiofrequency catheter ablation for supraventricular tachyarrhythmias. 10,11 In the past decade, this complication has also been observed following ablation therapy for atrial fibrillation (AF). 12 It is crucial for thoracic and cardiovascular physicians and surgeons to understand the detailed, bilateral anatomy of PN to avoid its injury.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional imaging and mapping of the right and left phrenic nerves: relevance to interventional cardiovascular therapy

Fukumoto¹,

Takatsuki²,

Jinzaki³

et al. 2013

EP Europace

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AimsPhrenic nerves (PNs) can be damaged during interventional cardiovascular therapy because of the nerves' proximity to the heart. This study aimed to analyse the anatomy of the PN by performing three-dimensional (3-D) imaging and pace mapping. Methods and resultsForty consecutive patients with atrial fibrillation referred for catheter ablation were enrolled in this study and underwent preoperative cardiovascular computed tomography (CT). In 10 patients with sinus rhythm during tomography, 3-D images of the right and left pericardiophrenic bundles (PBs), consisting of the ipsilateral PN and accompanying vessels, were reconstructed from the CT data. During the electrophysiological study, PN pace mapping was performed from both atria. The course of the PBs generated by CT imaging and the PN pace map generated by the 3-D mapping system were compared. By electrical pacing, the PNs were captured in 40 individuals (100%) from the superior vena cava and the right atrium, and in 17 patients (43%) from the left atrial appendage. Clear 3-D images of PBs were reconstructed in all cases in which CT-reconstruction was performed. The distance between the locations of the right PB generated by CT imaging and those of the right PN-capture sites in the right-sided heart on the mapping system was 8.7 + 5.8 mm. ConclusionsThe 3-D routes of the bilateral PNs passing near the heart were verified by pace mapping. The preoperatively reconstructed 3-D course of the PB succeeded in locating the PN, which may facilitate the comprehension of PN anatomy to avoid its injury during interventional cardiovascular therapy.--

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“…There are few other reports of neurologic damage following RFA and none involving the anterior rami of the nerve roots. Left phrenic nerve paralysis has occurred as a complication of cardiac radiofrequency ablation for management of arrhythmias 2,9 and facet denervation in the management of back pain has resulted in midline numbness, 11 presumably due to damage of the posterior rami of lumbar roots.…”

Section: Discussionmentioning

confidence: 99%

Lumbosacral radiculopathy following radiofrequency ablation therapy

2003

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Radiofrequency ablation (RFA) is a treatment modality for several types of malignancies and vascular malformations. Only limited information is available on neurologic complications following RFA. We report three cases of acute lumbosacral radiculopathy after abdominal RFA, in two of which electrophysiologic studies were performed. All three patients had significant spontaneous clinical improvement. We suggest the underlying cause was partial axonopathy due to thermal injury, but with a good prognosis.

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Left phrenic nerve paresis complicating catheter radiofrequency ablation for Wolff-Parkinson-White syndrome

Cited by 39 publications

References 5 publications

Myocardial Lesion Size After Epicardial Electroporation Catheter Ablation After Subxiphoid Puncture

Myocardial Lesion Size After Epicardial Electroporation Catheter Ablation After Subxiphoid Puncture

Three-dimensional imaging and mapping of the right and left phrenic nerves: relevance to interventional cardiovascular therapy

Lumbosacral radiculopathy following radiofrequency ablation therapy

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