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• W2893189448 abstract "This study sought to investigate the incidence of phrenic nerve (PN) limitation and the utility of displacing the PN with a balloon. The PN can limit the epicardial ablation of ventricular tachycardia (VT). From 2010 to 2017, 363 patients undergoing VT epicardial ablation at a single center were studied. Before the ablation, we used high output (20-mA) pacing maneuvers to verify the course of the PN. When we observed its capture, we used 1 of 3 different approaches to protect it: 1) non-balloon strategy (nerve-sparing ablation); 2) PN displacement with a small balloon (6 mm × 20 mm); or 3) PN displacement with a large balloon (20 mm × 45 mm). PN capture occurred in 25 patients (7%) at the target ablation site. The most common cause was myocarditis (12 patients [48%]), and the incidence of the PN limitation was significantly higher in myocarditis than in other causes (19% vs. 4%, respectively; p = 0.0002). PN displacement was attempted in 7 patients by using large balloons and in 6 patients with small balloons, resulting in successful PN displacements and complete late potential (LP) abolition in 6 patients (86%) and 3 patients (50%), respectively. Among the 12 patients in whom the non-balloon strategy was used, only 1 patient (8%) achieved LP abolition (compared with the large balloon group; p = 0.002), whereas 3 patients experienced PN paralysis. The PN limited the epicardial ablation in 7% of patients. Because nerve-sparing ablations often resulted in PN injuries, a possible solution could be to displace the PN with a large balloon, leading to a safer procedure and completion of LP abolition." @default.
• W2893189448 created "2018-10-05" @default.
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• W2893189448 date "2019-01-01" @default.
• W2893189448 modified "2023-10-18" @default.
• W2893189448 title "Phrenic Nerve Limitation During Epicardial Catheter Ablation of Ventricular Tachycardia" @default.
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• W2893189448 doi "https://doi.org/10.1016/j.jacep.2018.08.011" @default.
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