Identificación del nervio frénico con tomografía computarizada cardiaca multidetector / Phrenic nerve identification with cardiac multidetector computed tomography

La crioablación con balón de las venas pulmonares es una técnica novedosa que se ha demostrado útil para prevenir las recurrencias de la fibrilación auricular paroxística y persistente. Una de las complicaciones más relevantes del procedimiento es la parálisis del nervio frénico derecho. Se ha descrito recientemente la utilidad de la tomografía computarizada multidetector para localizar el recorrido de la arteria y el nervio frénico y predecir el riesgo de parálisis frénica durante la crioablación, según la distancia del paquete vasculonervioso frénico derecho al ostium de la vena pulmonar superior derecha. A 55 pacientes consecutivos con fibrilación auricular paroxística (media de edad 52±12 años) sometidos a crioablación con balón, se les realizó estudio previo con tomografía computarizada multidetector para medir el tamaño de las venas pulmonares. Se pudo identificar algún fragmento de la arteria pericardiofrénica derecha en 10 pacientes (20%), con una longitud media de 25 (7-68) mm (AU)

Cryoballoon ablation of the pulmonary veins is a new technique that has proven useful in preventing paroxysmal and persistent atrial fibrillation recurrence. One of the most serious complications of this method is right phrenic nerve palsy. The usefulness of multidetector computed tomography to locate the right phrenic nerve and artery and predict the risk of phrenic nerve palsy during cryoablation according to the distance between the right phrenic neurovascular bundle and the right superior pulmonary vein ostium has recently been described. Fifty-five consecutive patients with paroxysmal atrial fibrillation (52±12 years) underwent balloon cryoablation, following multidetector computed tomography to measure the pulmonary veins. We were able to identify segments of the right pericardiacophrenic artery (mean length 25mm [range 7-68mm]) in only 10 patients (20%) (AU)

[Phrenic nerve identification with cardiac multidetector computed tomography]. / Identificación del nervio frénico con tomografía computarizada cardiaca multidetector.

Cryoballoon ablation of the pulmonary veins is a new technique that has proven useful in preventing paroxysmal and persistent atrial fibrillation recurrence. One of the most serious complications of this method is right phrenic nerve palsy. The usefulness of multidetector computed tomography to locate the right phrenic nerve and artery and predict the risk of phrenic nerve palsy during cryoablation according to the distance between the right phrenic neurovascular bundle and the right superior pulmonary vein ostium has recently been described. Fifty-five consecutive patients with paroxysmal atrial fibrillation (52 ± 12 years) underwent balloon cryoablation, following multidetector computed tomography to measure the pulmonary veins. We were able to identify segments of the right pericardiacophrenic artery (mean length 25 mm [range 7-68 mm]) in only 10 patients (20%).