Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Heeger, CH; Sohns, C; Pott, A; Metzner, A; Inaba, O; Straube, F; Kuniss, M; Aryana, A; Miyazaki, S; Cay, S; Ehrlich, JR; El-Battrawy, I; Martinek, M; Saguner, AM; Tscholl, V; Yalin, K; Lyan, E; Su, W; Papiashvili, G; Botros, MSN; Gasperetti, A; Proietti, R; Wissner, E; Scherr, D; Kamioka, M; Makimoto, H; Urushida, T; Aksu, T; Chun, JKR; Aytemir, K; Jędrzejczyk-Patej, E; Kuck, KH; Dahme, T; Steven, D; Sommer, P; Richard, Tilz, R.
Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry.
Circ Arrhythm Electrophysiol. 2022; 15(1):e010516
Doi: 10.1161/CIRCEP.121.010516
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- Co-Autor*innen der Med Uni Graz
- Scherr Daniel
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- Abstract:
- BACKGROUND: Cryoballoon-based pulmonary vein isolation (PVI) has emerged as an effective treatment for atrial fibrillation. The most frequent complication during cryoballoon-based PVI is phrenic nerve injury (PNI). However, data on PNI are scarce. METHODS: The YETI registry is a retrospective, multicenter, and multinational registry evaluating the incidence, characteristics, prognostic factors for PNI recovery and follow-up data of patients with PNI during cryoballoon-based PVI. Experienced electrophysiological centers were invited to participate. All patients with PNI during CB2 or third (CB3) and fourth-generation cryoballoon (CB4)-based PVI were eligible. RESULTS: A total of 17 356 patients underwent cryoballoon-based PVI in 33 centers from 10 countries. A total of 731 (4.2%) patients experienced PNI. The mean time to PNI was 127.7±50.4 seconds, and the mean temperature at the time of PNI was -49±8°C. At the end of the procedure, PNI recovered in 394/731 patients (53.9%). Recovery of PNI at 12 months of follow-up was found in 97.0% of patients (682/703, with 28 patients lost to follow-up). A total of 16/703 (2.3%) reported symptomatic PNI. Only 0.06% of the overall population showed symptomatic and permanent PNI. Prognostic factors improving PNI recovery are immediate stop at PNI by double-stop technique and utilization of a bonus-freeze protocol. Age, cryoballoon temperature at PNI, and compound motor action potential amplitude loss >30% were identified as factors decreasing PNI recovery. Based on these parameters, a score was calculated. The YETI score has a numerical value that will directly represent the probability of a specific patient of recovering from PNI within 12 months. CONCLUSIONS: The incidence of PNI during cryoballoon-based PVI was 4.2%. Overall 97% of PNI recovered within 12 months. Symptomatic and permanent PNI is exceedingly rare in patients after cryoballoon-based PVI. The YETI score estimates the prognosis after iatrogenic cryoballoon-derived PNI. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03645577. Graphic Abstract: A graphic abstract is available for this article.
- Find related publications in this database (Keywords)
- atrial fibrillation
- catheter ablation
- cryoballoon
- incidence
- phrenic nerve injury