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Phrenic Relocation by Endoscopy, Intentional Pneumothorax Using Carbon Dioxide, and Single Lung Ventilation
Rajan L Shah1, Alexander Perino2, Paul Wang2
1Division of Cardiovascular Medicine, Stanford Health Care, Palo Alto, California, USA; Section of Cardiac Electrophysiology, University Medical Partners, Oakland, California, USA. Electronic address: https://twitter.com/atrialappendage.
JACC. Clinical Electrophysiology
|May 24, 2023
Summary
A new PHRENICS technique safely relocates the phrenic nerve (PN) during catheter ablation for atrial tachycardia (AT). This method prevents PN injury, ensuring successful treatment without recurrence or complications.
Area of Science:
- Cardiology
- Electrophysiology
- Thoracic Surgery
Background:
- Phrenic nerve (PN) injury is a risk during catheter ablation for periphrenic atrial tachycardia (AT).
- Current PN protection strategies can be challenging, ineffective, or carry risks.
Purpose of the Study:
- To evaluate a novel hybrid technique, PHRENICS, for phrenic nerve (PN) sparing during catheter ablation of multidrug-refractory periphrenic atrial tachycardia (AT).
Main Methods:
- Prospective evaluation of the PHRENICS technique.
- PHRENICS involves single lung ventilation and intentional pneumothorax using carbon dioxide.
- This hybrid approach aims to relocate the PN away from the ablation target site.
Main Results:
- The PHRENICS technique successfully relocated the PN in all patients.
- Effective catheter ablation of AT was achieved without procedural complications.
- No arrhythmia recurrence was observed post-procedure.
Conclusions:
- The PHRENICS hybrid ablation technique effectively mobilizes the phrenic nerve.
- This approach avoids unnecessary pericardial invasion, enhancing safety.
- PHRENICS expands the safety of catheter ablation for periphrenic AT.
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