Heeger, Christian-H, Sohns, Christian, Pott, Alexander, Metzner, Andreas, Inaba, Osamu, Straube, Florian ORCID: 0000-0002-4491-5224, Kuniss, Malte, Aryana, Arash, Miyazaki, Shinsuke, Cay, Serkan, Ehrlich, Joachim R., El-Battrawy, Ibrahim ORCID: 0000-0002-0139-1045, Martinek, Martin, Saguner, Ardan M., Tscholl, Verena, Yalin, Kivanc, Lyan, Evgeny, Su, Wilber, Papiashvili, Giorgi, Botros, Maichel Sobhy Naguib ORCID: 0000-0003-1521-1495, Gasperetti, Alessio, Proietti, Riccardo, Wissner, Erik ORCID: 0000-0002-7033-567X, Scherr, Daniel, Kamioka, Masashi, Makimoto, Hisaki, Urushida, Tsuyoshi, Aksu, Tolga, Chun, Julian K. R., Aytemir, Kudret, Jedrzejczyk-Patej, Ewa, Kuck, Karl-Heinz, Dahme, Tillman ORCID: 0000-0002-6211-7162, Steven, Daniel, Sommer, Philipp and Tilz, Roland Richard (2022). Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry. Circ.-Arrhythmia Electrophysiol., 15 (1). S. 23 - 33. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1941-3084

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Abstract

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 degrees 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Heeger, Christian-HUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sohns, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pott, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Metzner, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Inaba, OsamuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Straube, FlorianUNSPECIFIEDorcid.org/0000-0002-4491-5224UNSPECIFIED
Kuniss, MalteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aryana, ArashUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miyazaki, ShinsukeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cay, SerkanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ehrlich, Joachim R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
El-Battrawy, IbrahimUNSPECIFIEDorcid.org/0000-0002-0139-1045UNSPECIFIED
Martinek, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saguner, Ardan M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tscholl, VerenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yalin, KivancUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lyan, EvgenyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Su, WilberUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papiashvili, GiorgiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Botros, Maichel Sobhy NaguibUNSPECIFIEDorcid.org/0000-0003-1521-1495UNSPECIFIED
Gasperetti, AlessioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Proietti, RiccardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wissner, ErikUNSPECIFIEDorcid.org/0000-0002-7033-567XUNSPECIFIED
Scherr, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kamioka, MasashiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Makimoto, HisakiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Urushida, TsuyoshiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aksu, TolgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chun, Julian K. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aytemir, KudretUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jedrzejczyk-Patej, EwaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuck, Karl-HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dahme, TillmanUNSPECIFIEDorcid.org/0000-0002-6211-7162UNSPECIFIED
Steven, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sommer, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tilz, Roland RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-698832
DOI: 10.1161/CIRCEP.121.010516
Journal or Publication Title: Circ.-Arrhythmia Electrophysiol.
Volume: 15
Number: 1
Page Range: S. 23 - 33
Date: 2022
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1941-3084
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
2ND-GENERATION CRYOBALLOON; ATRIAL-FIBRILLATION; ABLATION; EXPERIENCE; FREEZE; PALSY; TIMEMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69883

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