Three-dimensional imaging and mapping of the right and left phrenic nerves

Relevance to interventional cardiovascular therapy

Kotaro Fukumoto, Seiji Takatsuki, Masahiro Jinzaki, Minoru Yamada, Kojiro Tanimoto, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Yoko Hagiwara, Yukiko Fukuda, Takehiro Kimura, Shunichiro Miyoshi, Sachio Kuribayashi, Keiichi Fukuda

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)937-943
Number of pages7
JournalEuropace
Volume15
Issue number7
DOIs
Publication statusPublished - 2013 Jul

Fingerprint

Phrenic Nerve
Three-Dimensional Imaging
Tomography
Anatomy
Therapeutics
Atrial Appendage
Superior Vena Cava
Catheter Ablation
Heart Atria
Atrial Fibrillation
Wounds and Injuries

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Computed tomography
  • Open chest surgery
  • Phrenic nerve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Three-dimensional imaging and mapping of the right and left phrenic nerves : Relevance to interventional cardiovascular therapy. / Fukumoto, Kotaro; Takatsuki, Seiji; Jinzaki, Masahiro; Yamada, Minoru; Tanimoto, Kojiro; Nishiyama, Nobuhiro; Aizawa, Yoshiyasu; Hagiwara, Yoko; Fukuda, Yukiko; Kimura, Takehiro; Miyoshi, Shunichiro; Kuribayashi, Sachio; Fukuda, Keiichi.

In: Europace, Vol. 15, No. 7, 07.2013, p. 937-943.

Research output: Contribution to journalArticle

Fukumoto, K, Takatsuki, S, Jinzaki, M, Yamada, M, Tanimoto, K, Nishiyama, N, Aizawa, Y, Hagiwara, Y, Fukuda, Y, Kimura, T, Miyoshi, S, Kuribayashi, S & Fukuda, K 2013, 'Three-dimensional imaging and mapping of the right and left phrenic nerves: Relevance to interventional cardiovascular therapy', Europace, vol. 15, no. 7, pp. 937-943. https://doi.org/10.1093/europace/eus439
Fukumoto, Kotaro ; Takatsuki, Seiji ; Jinzaki, Masahiro ; Yamada, Minoru ; Tanimoto, Kojiro ; Nishiyama, Nobuhiro ; Aizawa, Yoshiyasu ; Hagiwara, Yoko ; Fukuda, Yukiko ; Kimura, Takehiro ; Miyoshi, Shunichiro ; Kuribayashi, Sachio ; Fukuda, Keiichi. / Three-dimensional imaging and mapping of the right and left phrenic nerves : Relevance to interventional cardiovascular therapy. In: Europace. 2013 ; Vol. 15, No. 7. pp. 937-943.
@article{a4e237ff9a33475489082fecc470e7e9,
title = "Three-dimensional imaging and mapping of the right and left phrenic nerves: Relevance to interventional cardiovascular therapy",
abstract = "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.",
keywords = "Atrial fibrillation, Catheter ablation, Computed tomography, Open chest surgery, Phrenic nerve",
author = "Kotaro Fukumoto and Seiji Takatsuki and Masahiro Jinzaki and Minoru Yamada and Kojiro Tanimoto and Nobuhiro Nishiyama and Yoshiyasu Aizawa and Yoko Hagiwara and Yukiko Fukuda and Takehiro Kimura and Shunichiro Miyoshi and Sachio Kuribayashi and Keiichi Fukuda",
year = "2013",
month = "7",
doi = "10.1093/europace/eus439",
language = "English",
volume = "15",
pages = "937--943",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Three-dimensional imaging and mapping of the right and left phrenic nerves

T2 - Relevance to interventional cardiovascular therapy

AU - Fukumoto, Kotaro

AU - Takatsuki, Seiji

AU - Jinzaki, Masahiro

AU - Yamada, Minoru

AU - Tanimoto, Kojiro

AU - Nishiyama, Nobuhiro

AU - Aizawa, Yoshiyasu

AU - Hagiwara, Yoko

AU - Fukuda, Yukiko

AU - Kimura, Takehiro

AU - Miyoshi, Shunichiro

AU - Kuribayashi, Sachio

AU - Fukuda, Keiichi

PY - 2013/7

Y1 - 2013/7

N2 - 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.

AB - 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.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Computed tomography

KW - Open chest surgery

KW - Phrenic nerve

UR - http://www.scopus.com/inward/record.url?scp=84879572656&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879572656&partnerID=8YFLogxK

U2 - 10.1093/europace/eus439

DO - 10.1093/europace/eus439

M3 - Article

VL - 15

SP - 937

EP - 943

JO - Europace

JF - Europace

SN - 1099-5129

IS - 7

ER -