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Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry

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Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry. / Heeger, Christian-H; Sohns, Christian; Pott, Alexander; Metzner, Andreas; Inaba, Osamu; Straube, Florian; Kuniss, Malte; Aryana, Arash; Miyazaki, Shinsuke; Cay, Serkan; Ehrlich, Joachim R; El-Battrawy, Ibrahim; Martinek, Martin; Saguner, Ardan M; Tscholl, Verena; Yalin, Kivanc; Lyan, Evgeny; Su, Wilber; Papiashvili, Giorgi; Botros, Maichel Sobhy Naguib; Gasperetti, Alessio; Proietti, Riccardo; Wissner, Erik; Scherr, Daniel; Kamioka, Masashi; Makimoto, Hisaki; Urushida, Tsuyoshi; Aksu, Tolga; Chun, Julian K R; Aytemir, Kudret; Jędrzejczyk-Patej, Ewa; Kuck, Karl-Heinz; Dahme, Tillman; Steven, Daniel; Sommer, Philipp; Richard Tilz, Roland.

In: CIRC-ARRHYTHMIA ELEC, Vol. 15, No. 1, e010516, 01.2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Heeger, C-H, Sohns, C, Pott, A, Metzner, A, Inaba, O, Straube, F, Kuniss, M, Aryana, A, Miyazaki, S, Cay, S, Ehrlich, JR, El-Battrawy, I, Martinek, M, Saguner, AM, Tscholl, V, Yalin, K, Lyan, E, Su, W, Papiashvili, G, Botros, MSN, Gasperetti, A, Proietti, R, Wissner, E, Scherr, D, Kamioka, M, Makimoto, H, Urushida, T, Aksu, T, Chun, JKR, Aytemir, K, Jędrzejczyk-Patej, E, Kuck, K-H, Dahme, T, Steven, D, Sommer, P & Richard Tilz, R 2022, 'Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry', CIRC-ARRHYTHMIA ELEC, vol. 15, no. 1, e010516. https://doi.org/10.1161/CIRCEP.121.010516

APA

Heeger, C-H., Sohns, C., Pott, A., Metzner, A., Inaba, O., Straube, F., Kuniss, M., Aryana, A., Miyazaki, S., Cay, S., Ehrlich, J. R., El-Battrawy, I., Martinek, M., Saguner, A. M., Tscholl, V., Yalin, K., Lyan, E., Su, W., Papiashvili, G., ... Richard Tilz, R. (2022). Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry. CIRC-ARRHYTHMIA ELEC, 15(1), [e010516]. https://doi.org/10.1161/CIRCEP.121.010516

Vancouver

Heeger C-H, Sohns C, Pott A, Metzner A, Inaba O, Straube F et al. Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry. CIRC-ARRHYTHMIA ELEC. 2022 Jan;15(1). e010516. https://doi.org/10.1161/CIRCEP.121.010516

Bibtex

@article{78d6a0d20bcd4ea1b4b32e2b96e9144f,
title = "Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry",
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°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. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03645577. Graphic Abstract: A graphic abstract is available for this article.",
author = "Christian-H Heeger and Christian Sohns and Alexander Pott and Andreas Metzner and Osamu Inaba and Florian Straube and Malte Kuniss and Arash Aryana and Shinsuke Miyazaki and Serkan Cay and Ehrlich, {Joachim R} and Ibrahim El-Battrawy and Martin Martinek and Saguner, {Ardan M} and Verena Tscholl and Kivanc Yalin and Evgeny Lyan and Wilber Su and Giorgi Papiashvili and Botros, {Maichel Sobhy Naguib} and Alessio Gasperetti and Riccardo Proietti and Erik Wissner and Daniel Scherr and Masashi Kamioka and Hisaki Makimoto and Tsuyoshi Urushida and Tolga Aksu and Chun, {Julian K R} and Kudret Aytemir and Ewa J{\c e}drzejczyk-Patej and Karl-Heinz Kuck and Tillman Dahme and Daniel Steven and Philipp Sommer and {Richard Tilz}, Roland",
year = "2022",
month = jan,
doi = "10.1161/CIRCEP.121.010516",
language = "English",
volume = "15",
journal = "CIRC-ARRHYTHMIA ELEC",
issn = "1941-3149",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

RIS

TY - JOUR

T1 - Phrenic Nerve Injury During Cryoballoon-Based Pulmonary Vein Isolation: Results of the Worldwide YETI Registry

AU - Heeger, Christian-H

AU - Sohns, Christian

AU - Pott, Alexander

AU - Metzner, Andreas

AU - Inaba, Osamu

AU - Straube, Florian

AU - Kuniss, Malte

AU - Aryana, Arash

AU - Miyazaki, Shinsuke

AU - Cay, Serkan

AU - Ehrlich, Joachim R

AU - El-Battrawy, Ibrahim

AU - Martinek, Martin

AU - Saguner, Ardan M

AU - Tscholl, Verena

AU - Yalin, Kivanc

AU - Lyan, Evgeny

AU - Su, Wilber

AU - Papiashvili, Giorgi

AU - Botros, Maichel Sobhy Naguib

AU - Gasperetti, Alessio

AU - Proietti, Riccardo

AU - Wissner, Erik

AU - Scherr, Daniel

AU - Kamioka, Masashi

AU - Makimoto, Hisaki

AU - Urushida, Tsuyoshi

AU - Aksu, Tolga

AU - Chun, Julian K R

AU - Aytemir, Kudret

AU - Jędrzejczyk-Patej, Ewa

AU - Kuck, Karl-Heinz

AU - Dahme, Tillman

AU - Steven, Daniel

AU - Sommer, Philipp

AU - Richard Tilz, Roland

PY - 2022/1

Y1 - 2022/1

N2 - 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°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. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03645577. Graphic Abstract: A graphic abstract is available for this article.

AB - 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°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. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03645577. Graphic Abstract: A graphic abstract is available for this article.

U2 - 10.1161/CIRCEP.121.010516

DO - 10.1161/CIRCEP.121.010516

M3 - SCORING: Journal article

C2 - 34962134

VL - 15

JO - CIRC-ARRHYTHMIA ELEC

JF - CIRC-ARRHYTHMIA ELEC

SN - 1941-3149

IS - 1

M1 - e010516

ER -