| Description: |
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: ... |
| Relation: |
https://livrepository.liverpool.ac.uk/3154756/1/Phrenic%20Nerve%20Injury%20During%20Cryoballoon-Based%20Pulmonary%20Vein%20Isolation%20Results%20of%20the%20Worldwide%20YETI%20Registry.pdf; Collapse authors list. Heeger, CH orcid:0000-0002-9014-8097 , Sohns, C orcid:0000-0003-0490-5862 , Pott, A, Metzner, A, Inaba, O orcid:0000-0003-2179-3786 , Straube, F orcid:0000-0002-4491-5224 , Kuniss, M orcid:0000-0002-1593-9657 , Aryana, A orcid:0000-0003-0932-8400 , Miyazaki, S orcid:0000-0002-0230-0934 , Cay, S orcid:0000-0002-5476-1214 et al (show 26 more authors) , Ehrlich, JR orcid:0000-0002-5803-9843 , El-Battrawy, I orcid:0000-0002-0139-1045 , Martinek, M orcid:0000-0002-8895-8488 , Saguner, AM orcid:0000-0003-1896-0803 , Tscholl, V orcid:0000-0003-2748-2540 , Yalin, K orcid:0000-0001-5602-0711 , Lyan, E orcid:0000-0001-9696-9227 , Su, W orcid:0000-0002-6183-6683 , Papiashvili, G, Botros, MSN orcid:0000-0003-1521-1495 , Gasperetti, A orcid:0000-0003-3432-070X , Proietti, R orcid:0000-0003-4113-7030 , Wissner, E, Scherr, D, Kamioka, M orcid:0000-0001-6588-0764 , Makimoto, H, Urushida, T, Aksu, T orcid:0000-0001-8061-9660 , Chun, JKR orcid:0000-0002-2355-6015 , Aytemir, K orcid:0000-0001-9279-8424 , Jȩdrzejczyk-Patej, E orcid:0000-0002-1009-0076 , Kuck, KH orcid:0000-0003-2649-3870 , Dahme, T orcid:0000-0002-6211-7162 , Steven, D, Sommer, P orcid:0000-0002-3037-8704 and Richard Tilz, R orcid:0000-0002-0122-7130 (2022) Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry Circulation Arrhythmia and Electrophysiology, 15 (1). E010516-. ISSN 1941-3149, 1941-3084 |