{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:01:42Z","timestamp":1758636102599},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,5,18]],"date-time":"2014-05-18T00:00:00Z","timestamp":1400371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Monitoring of Phrenic Nerve During Cryoballoon Ablation<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Right phrenic nerve palsy (PNP) is a typical complication of cryoballoon ablation of the right\u2010sided pulmonary veins (PVs). Phrenic nerve function can be monitored by palpating the abdomen during phrenic nerve pacing from the superior vena cava (SVC pacing) or by fluoroscopy of spontaneous breathing. We sought to compare the sensitivity of these 2 techniques during cryoballoon ablation for detection of PNP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A total of 133 patients undergoing cryoballoon ablation were monitored with both SVC pacing and fluoroscopy of spontaneous breathing during ablation of the right superior PV. PNP occurred in 27\/133 patients (20.0%). Most patients (89%) had spontaneous recovery of phrenic nerve function at the end of the procedure or on the following day. Three patients were discharged with persistent PNP. All PNP were detected first by fluoroscopic observation of diaphragm movement during spontaneous breathing, while diaphragm could still be stimulated by SVC pacing. In patients with no recovery until discharge, PNP occurred at a significantly earlier time (86 \u00b1 34\u00a0seconds vs. 296 \u00b1 159\u00a0seconds, P &lt; 0.001). No recovery occurred in 2\/4 patients who were ablated with a 23\u00a0mm cryoballoon as opposed to 1\/23 patients with a 28\u00a0mm cryoballoon (P = 0.049).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fluoroscopic assessment of diaphragm movement during spontaneous breathing is more sensitive for detection PNP as compared to SVC pacing. PNP as assessed by fluoroscopy is frequent (20.0%) and carries a high rate of recovery (89%) until discharge. Early onset of PNP and use of 23\u00a0mm cryoballoon are associated with PNP persisting beyond hospital discharge.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12431","type":"journal-article","created":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T18:20:49Z","timestamp":1397240449000},"page":"859-865","source":"Crossref","is-referenced-by-count":21,"title":["Fluoroscopy of Spontaneous Breathing is More Sensitive Than Phrenic Nerve Stimulation for Detection of Right Phrenic Nerve Injury During Cryoballoon Ablation of Atrial Fibrillation"],"prefix":"10.1111","volume":"25","author":[{"given":"MARKUS","family":"LINHART","sequence":"first","affiliation":[{"name":"Medizinische Klinik und Poliklinik II Universit\u00e4tsklinikum Bonn M.D  Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANNIKA","family":"NIELSON","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II Universit\u00e4tsklinikum Bonn M.D  Bonn 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