Electrical Isolation of Superior Vena Cava Using Upstream PN Pacing to Avoid Phrenic Nerve Injury

Takehiro Kimura, Seiji Takatsuki, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoshiyasu Aizawa, Yukiko Karube, Shunichiro Miyoshi, Keiichi Fukuda

研究成果: Article

抄録

Background: Phrenic nerve (PN) injury is a potential complication during superior vena cava (SVC) isolation to cure atrial fibrillation (AF). Avoiding radiofrequency (RF) energy delivery is safer but may lead to a failed isolation. High-output PN pacing above the ablation site, upstream PN pacing, is a promising technique to avoid PN injury. This study was conducted to elucidate the safety of delivering RF energy at the site where high-output pacing captures PN. Methods and Results: SVC isolation was carried out in 41 drug-resistant AF patients. When high-output pacing (25 mA) from the ablation catheter captured PN, upstream PN pacing (cycle length: 1000-1500msec) was applied during RF delivery. RF energy was ceased upon the failure or weakness of diaphragmatic twitching. The feasibility of SVC isolation using upstream PN pacing was investigated. In all 41 patients, SVC isolation was successfully achieved. RF energy was delivered at the PN capture site in 26 patients (154± 138 sec, 18± 5 W), and upstream PN pacing was successfully applied in all patients. Out of 46 SVC isolations, including 5 redo sessions, PN injury occurred in 2 patients, who recovered spontaneously within 2 weeks. Conclusions: Upstream PN pacing is effective in completing SVC isolation safely and reducing the severity of PN injury.

元の言語English
ジャーナルJournal of Arrhythmia
27
DOI
出版物ステータスPublished - 2011

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Phrenic Nerve
Superior Vena Cava
Wounds and Injuries
Atrial Fibrillation
Catheter Ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

これを引用

Electrical Isolation of Superior Vena Cava Using Upstream PN Pacing to Avoid Phrenic Nerve Injury. / Kimura, Takehiro; Takatsuki, Seiji; Nishiyama, Nobuhiro; Fukumoto, Kotaro; Aizawa, Yoshiyasu; Karube, Yukiko; Miyoshi, Shunichiro; Fukuda, Keiichi.

:: Journal of Arrhythmia, 巻 27, 2011.

研究成果: Article

Kimura, Takehiro ; Takatsuki, Seiji ; Nishiyama, Nobuhiro ; Fukumoto, Kotaro ; Aizawa, Yoshiyasu ; Karube, Yukiko ; Miyoshi, Shunichiro ; Fukuda, Keiichi. / Electrical Isolation of Superior Vena Cava Using Upstream PN Pacing to Avoid Phrenic Nerve Injury. :: Journal of Arrhythmia. 2011 ; 巻 27.
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AU - Kimura, Takehiro

AU - Takatsuki, Seiji

AU - Nishiyama, Nobuhiro

AU - Fukumoto, Kotaro

AU - Aizawa, Yoshiyasu

AU - Karube, Yukiko

AU - Miyoshi, Shunichiro

AU - Fukuda, Keiichi

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KW - ablation

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