ArticleHeart rhythm O22025
An alternative method for phrenic nerve monitoring during cryoballoon procedures.
Article in Heart rhythm O2, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Phrenic nerve palsy during cryoballoon ablation of atrial fibrillation: a minor complication or a wolf in sheep's clothing? Insights on late arrhythmia recurrences from a propensity score-matched analysis.Frontiers in cardiovascular medicine · 2025Article
- Cryoablation for atrial fibrillation: biophysics and a contemporary step-by-step approach.Indian pacing and electrophysiology journalReview
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Cryoballoon ablation is associated with a consistent risk of phrenic nerve (PN) damage. Abdominal palpation associated with other strategies such as the diaphragmatic compound motor action potential (CMAP) has been shown to be an effective and reliable method for preventing this complication. Objective: The purpose of this study was to evaluate the diagnostic performance of a new surface CMAP electrodes positioning. Methods: A total of 150 patients underwent cryoballoon ablation. During the procedure, we placed the CMAP leads per the manufacturer's instructions and our alternative method, named NeedMAP, by placing electrocardiographic electrodes on the anterior axillary line. We simultaneously recorded the CMAP and the NeedMAP. CMAP monitoring with a 35% decrease cutoff for the diagnosis of nerve threatening was considered the gold standard. The NeedMAP decrease threshold also was set at 35%. Results: A total of 438 cryoballoon applications were performed on the right pulmonary veins. Mean CMAP amplitude was 0.60 ± 0.33 mV compared to NeedMAP amplitude 0.85 ± 0.46 mV ( Conclusion: The NeedMAP signal for PN monitoring during cryoballoon ablation seems to be a reliable method, shows good sensitivity and specificity, and can help clinicians in preventing PN damage.
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