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A Novel Technique for Diaphragmatic Compound Motor Action Potential Monitoring Using the BeeAT Catheter During
Keigo Yamamoto1, Takeshi Goto1, Masaomi Kimura2
1Department of Clinical Engineering Hirosaki University School of Medicine and Hospital Hirosaki, Aomori Japan.
Background:
Diaphragmatic compound motor action potential (CMAP) monitoring helps prevent phrenic nerve palsy during cryoballoon ablation (CBA) for atrial fibrillation.
Methods:
This retrospective analysis included 95 patients who had undergone CBA. Phrenic nerve pacing was performed via the distal electrode of a BeeAT catheter positioned in the right subclavian vein, with CMAPs recorded from the most proximal electrode in the subdiaphragmatic inferior vena cava.
Results:
CMAP amplitude was unaffected by patient body habitus (mean: 1.14 ± 0.58 mV; CMAP-to-ventricular wave ratio: 8.76).
Conclusions:
This technique provides stable, well-defined signals with minimal artifacts, enhancing the reliability of CMAP monitoring during CBA.
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