{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:08:48Z","timestamp":1782601728643,"version":"3.54.5"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"\n Background<\/jats:title>\n \n Cryoballoon pulmonary vein isolation (\n PVI<\/jats:styled-content>\n ) has emerged as an alternative to radiofrequency\n PVI<\/jats:styled-content>\n for atrial fibrillation (\n AF<\/jats:styled-content>\n ). Data are lacking to define the rates and predictors of complications, particularly phrenic nerve injury (\n PNI<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We evaluated a single\u2010center prospective registry of 450 consecutive patients undergoing cryoballoon\n PVI<\/jats:styled-content>\n between 2011 and 2015. Patients were 59\u00b110\u00a0years old, 26% were women, 58% had hypertension, their mean\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n VAS<\/jats:styled-content>\n c score was 1.7\u00b11.3, 30% had persistent atrial fibrillation, and 92% received a second\u2010generation 28\u2010mm balloon. Predefined major complications were persistent\n PNI<\/jats:styled-content>\n , pericardial effusion, deep vein thrombosis, arteriovenous fistula, atrioesophageal fistula, bleeding requiring transfusion, stroke, and death.\n PNI<\/jats:styled-content>\n was categorized as persistent if it persisted after discharge from the laboratory. Logistic regression was performed to identify predictors of complications and specifically\n PNI<\/jats:styled-content>\n . We identified a major complication in 10 (2.2%) patients. In 49 (10.8%) patients, at least transient\n PNI<\/jats:styled-content>\n was observed; only 5 persisted beyond the procedure (1.1%). All cases of\n PNI<\/jats:styled-content>\n resolved eventually, with the longest time to resolution being 48\u00a0days. We also describe 2 cases of\n PNI<\/jats:styled-content>\n manifesting after the index hospitalization. Regression analysis identified 23\u2010mm balloon use (16.3% versus 5.2%, odds ratio 2.94,\n P<\/jats:italic>\n =0.011) and increased age (62.8\u00b17.7\u00a0versus 58.7\u00b10.12\u00a0years, odds ratio 1.058,\n P<\/jats:italic>\n =0.014) as independent significant predictors of\n PNI<\/jats:styled-content>\n . There were no significant predictors of major complications.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In a large contemporary cohort, cryoballoon\n PVI<\/jats:styled-content>\n is associated with low procedural risk, including lower rates of\n PNI<\/jats:styled-content>\n than previously reported. Older age and 23\u2010mm balloon use were associated with\n PNI<\/jats:styled-content>\n . Our low rate of\n PNI<\/jats:styled-content>\n may reflect more sensitive detection methods, including compound motor action potential monitoring and forced double\u2010deflation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.003724","type":"journal-article","created":{"date-parts":[[2016,7,22]],"date-time":"2016-07-22T01:34:18Z","timestamp":1469151258000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Incidence and Predictors of Complications During Cryoballoon Pulmonary Vein Isolation for Atrial Fibrillation"],"prefix":"10.1161","volume":"5","author":[{"given":"Emily N.","family":"Guhl","sequence":"first","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Siddoway","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Adelstein","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raveen","family":"Bazaz","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Mendenhall","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Nemec","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Saba","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schwartzman","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Voigt","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Center for Atrial Fibrillation, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"15","article-title":"Improved resource utilization with similar efficacy during early adoption of cryoballoon pulmonary vein isolation as compared with radiofrequency ablation for paroxysmal atrial fibrillation","volume":"7","author":"Siddoway D","year":"2015","unstructured":"Siddoway D, Friehling M, Voigt A, Saba S, Jain S. 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