SHM Converge Scientific Abstract ePoster Gallery-Breathing Ablated

Pdf Summary

The case report describes a rare complication of catheter ablation for atrial fibrillation. A 78-year-old man developed progressive shortness of breath two days after undergoing electrophysiology studies, radiofrequency ablation with pulmonary vein isolation, and cavo-tricuspid isthmus ablation for medication-resistant paroxysmal atrial fibrillation. Workup for cardiac ischemia and pulmonary causes was negative, but chest X-ray showed a newly elevated right hemidiaphragm compared with pre-procedure imaging. He was diagnosed with right phrenic nerve paralysis secondary to the ablation procedure.<br /><br />The report highlights that phrenic nerve injury can occur with ablation because the nerve lies close to common cardiac target areas, and this risk exists regardless of the energy modality used. Although symptomatic phrenic nerve paralysis is uncommon, it typically presents with dyspnea or a new cough. Most cases are self-limited and recover over 6 months to 2 years.<br /><br />Recommended management includes serial chest X-rays, observation, symptomatic treatment as needed, and close follow-up with cardiology.

Asset Subtitle

Mridula P. Talari

Meta Tag

Author List Camelia Chirculescu, Dakota Robertson, Damian H. Sooklal, Mridula P. Talari, Nirav N. Patel

Category Clinical Vignettes

Concept Phrenic Nerve Paralysis

Concept Hemidiaphragm Elevation

Concept Catheter Ablation

Concept Pulmonary Vein Isolation

Concept Phrenic Nerve

Distinguished Non-Finalist

Presenter Organization Johnston Memorial Hospital

Presenting Author Mridula P. Talari

Track Adult

Keywords

catheter ablation

atrial fibrillation

phrenic nerve paralysis

pulmonary vein isolation

cavo-tricuspid isthmus ablation

dyspnea

elevated hemidiaphragm

radiofrequency ablation

cardiac electrophysiology

right phrenic nerve injury

Phrenic Nerve Paralysis

Hemidiaphragm Elevation

Catheter Ablation

Pulmonary Vein Isolation

Phrenic Nerve