Atrial Fibrillation, Phrenic Nerve Paralysis
Conditions
Keywords
Pulmonary vein isolation, Atrial fibrillation ablation, Arrhythmia, Phrenic nerve, Tissue doppler imaging, Diaphragm kinetics
Brief summary
The purpose of this study to assess the diaphragm kinetics with Tissue Doppler Imaging in patients undergoing atrial fibrillation ablation with cryoballoon
Detailed description
This study is designed to evaluate the diaphragm kinetics with ultrasonography parameters in patients who underwent pulmonary vein isolation (PVI) for atrial fibrillation (AF) by Cryoballoon. Due to the proximity of the pulmonary veins to the phrenic nerve, phrenic nerve paralysis can be seen rarely during the procedure. In contemporary practice, phrenic nerve damage is detected by visual monitoring of diaphragm movement as a result of pacing with high output by placing the intracardiac stimulation catheter at the level of the superior vena cava. However, subclinical nerve damage may be critical regarding respiratory functions, especially in patients with comorbidities. It has been shown in the literature that the evaluation of diaphragm kinetics with Tissue Doppler Imaging (TDI) can be used in effective ventilation monitoring and weaning. However, this technique has not been used in patients who have previously undergone cryoballoon therapy. It is aimed to investigate the positive or negative effects on diaphragm kinetics, as a very cost-effective and rapidly accessible technique, with the help of this technique.
Interventions
DIAGNOSTIC_TESTTissue Doppler Imaging
With tissue Doppler ultrasonography (TDI), the maximum contraction rate of the diaphragm, maximum relaxation rate, and integral against time will be examined.
DIAGNOSTIC_TESTM Mode Imaging
Diaphragm displacement during inspiration and expiration will be measured with M mode imaging
Sponsors
Istanbul University - Cerrahpasa
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for AF ablation with a cryoballoon * ≥18 years old * Patients with interpretable diaphragm ultrasound before the operation * Patients giving informed consent
Exclusion criteria
* Patients who did not give consent * Patients with phrenic nerve palsy * Morbid obesity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Detection of subclinical phrenic nerve injury with changes in diaphragm kinetics, before and after the procedure | Preoperative baseline and postoperative first hour | Unlike the traditional method, diaphragm Tissue Doppler imaging (TDI) will be used to diagnose phrenic nerve injury in patients during cryoballoon ablation. This method aims to detect the damages that may have occurred even though no visible damage has occurred. The peak contraction velocity (PCV) that has been found to be effective on weaning success will be used in TDI. The literature shows that the PCV measured by TDI in healthy humans is 1.32 ⨦ 0.39 cm/sec. Based on this, the patient's baseline and post-procedure PCVs will be compared. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The effect of subclinical diaphragm damage on morbidity | Preoperative baseline and postoperative 24 hours | Side effects that may occur as a consequence of these will be observed in patients with subclinical diaphragm injury. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactDeniz Mutlu, MD
Outcome results
None listed