Evaluation of Diaphragmatic Electromyograms in Radiofrequency Ablation of Atrial Fibrillation: Prospective Study Comparing Different Monitoring Techniques

Autor: Takamitsu Takagi, Jin Iwasawa, Shinsuke Miyazaki, Hiroshi Taniguchi, Akio Kuroi, Kenzo Hirao, Yoshihisa Kanaji, Hitoshi Hachiya, Hiroaki Nakamura, Yoshito Iesaka, Eisuke Usui, Noboru Ichihara
Rok vydání: 2014
Předmět:
Zdroj: Journal of Cardiovascular Electrophysiology. 26:260-265
ISSN: 1045-3873
Popis: Diaphragmatic Electromyograms During AF AblationBackground The utility of compound motor action potential (CMAP) monitoring for anticipating phrenic nerve injury (PNI) during cryoballoon ablation has been reported. We sought to compare two different CMAP recording techniques and evaluated the feasibility during pulmonary vein antrum isolation (PVAI) and superior vena cava isolation (SVCI) using radiofrequency energy. Methods and Results Forty-two patients undergoing paroxysmal atrial fibrillation ablation were prospectively enrolled. SVCI was performed following PVAI if SVC potentials were observed. CMAPs were recorded 3 times (before and after PVAI, and after SVCI) simultaneously from surface electrodes (CMAPsuf) and a decapolar catheter in the subdiaphragmatic hepatic vein (CMAPabd). The baseline CMAPsuf and CMAPabd were 0.92 ± 0.36 and 0.65 ± 0.43 mV except in one case with catheter inaccessibility. The CMAPsuf did not correlate with the body mass index, or CMAPabd. In 2 and 9 patients, the CMAPsuf and CMAPabd amplitudes were 0.3 mV (39.2 ± 10.8 vs. 21.5 ± 6.6 mm, P 30% decrease was observed in 2 patients in both techniques. In both, no PNI was apparent on fluoroscopy or chest X-ray. Conclusions Stable evaluable CMAPs were obtained with the CMAPsuf in most patients. Monitoring with the CMAPabd could be an alternative and complementary method.
Databáze: OpenAIRE
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