{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:23:30Z","timestamp":1774311810244,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T00:00:00Z","timestamp":1430438400000},"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":[[2015,6]]},"abstract":"<jats:title>Bilateral Diaphragmatic CMAPs During Cryoablation<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left phrenic nerve injury (PNI) can occur during cryoballoon ablation of the left pulmonary veins (PVs). This study aimed to evaluate the feasibility of monitoring the bilateral phrenic nerve function during cryoballoon ablation of atrial fibrillation (AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty consecutive paroxysmal AF patients undergoing cryoballoon ablation using one 28\u2010mm second\u2010generation balloon were prospectively enrolled. Bilateral diaphragmatic compound motor action potentials (CMAPs) were obtained from modified surface electrodes by pacing from the bilateral subclavian veins, and monitored during 3\u2010minute cryoballoon applications at the ipsilateral PVs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred ninety of 202 PVs were successfully isolated exclusively using 28\u2010mm cryoballoons. CMAPs could be obtained in all except 3 cases with catheter inaccessibility in the left subclavian vein. The left and right CMAP amplitudes were similar at baseline (1.04 \u00b1 0.41 mV vs. 1.01 \u00b1 0.43 mV, P = 0.49). Among 105 left and 132 right PV applications while monitoring CMAPs, 2 (1.9%) and 13 (9.8%) applications were interrupted for a decreased CMAP amplitude (P = 0.01). Among them, CMAPs decreased due to right PNI in 4 applications\/patients and to catheter dislodgement in the remaining applications. PNI remained in 1 and recovered in the remaining 3 patients one day after the procedure. Applications without requiring interruptions exhibited no significant CMAP amplitude changes throughout the applications, and the time\u2010course pattern was similar between the bilateral CMAPs (P = 0.292).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A stable bilateral diaphragmatic CMAP could be similarly obtained during cryoballoon applications in the vast majority of patients. Monitoring CMAPs might be useful to anticipate not only right but also left PNI during cryoballoon ablation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12671","type":"journal-article","created":{"date-parts":[[2015,3,24]],"date-time":"2015-03-24T22:09:07Z","timestamp":1427234947000},"page":"622-628","source":"Crossref","is-referenced-by-count":36,"title":["Prospective Evaluation of Bilateral Diaphragmatic Electromyograms During Cryoballoon Ablation of Atrial Fibrillation"],"prefix":"10.1111","volume":"26","author":[{"given":"SHINSUKE","family":"MIYAZAKI","sequence":"first","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital  Tsuchiura Ibaraki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HITOSHI","family":"HACHIYA","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital  Tsuchiura Ibaraki 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