BACKGROUND Patients who are ventilator dependent as a result of combined cervical spinal cord injury and phrenic nerve lesions are generally considered to be unsuitable candidates for diaphragmatic pacing due to loss of phrenic nerve integrity and denervation of the diaphragm. There is limited data regarding efficacy of simultaneous nerve transfers and diaphragmatic pacemakers in the treatment ...

A 49-year-old woman underwent cryoballoon pulmonary vein isolation for paroxysmal atrial fibrillation. Right phrenic nerve palsy developed during submaximal phrenic nerve stimulation. Despite the inability to stimulate the phrenic nerve with pacing, diaphragmatic excursion during inspiration was preserved. This case demonstrates that submaximal threshold stimulation allows detection of early ph...

Phrenic nerve trauma in the absence of direct injury is unusual and may present diagnostic difficulty. Diaphragmatic paralysis resulting from phrenic nerve injury may closely mimic diaphragmatic rupture. This case highlights the value of magnetic resonance imaging in establishing diaphragmatic integrity and of ultrasonographic assessment during respiratory excursion in confirming diaphragmatic ...

BACKGROUND Phrenic nerve palsy remains the most frequent complication associated with cryoballoon-based pulmonary vein (PV) isolation. We sought to characterize our experience using a novel monitoring technique for the prevention of phrenic nerve palsy. METHODS AND RESULTS Two hundred consecutive cryoballoon-based PV isolation procedures between October 2010 and October 2013 were studied. In ...

Background/Introduction Phrenic nerve palsy (PNP) is a well-recognized complication after cardiac surgery which might occur as a result of topical myocardial cooling, direct injury or ischemia. It can result in deleterious respiratory effects especially in children and in patient with chronic obstructive pulmonary disease which adversely affect recovery and increase the length of ICU and hospit...

We report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not requ...

BACKGROUND Unilateral diaphragmatic paralysis causes respiratory deficits and can occur after iatrogenic or traumatic phrenic nerve injury in the neck or chest. Patients are evaluated using spirometry and imaging studies; however, phrenic nerve conduction studies and electromyography are not widely available or considered; thus, the degree of dysfunction is often unknown. Treatment has been lim...

Patent ductus arteriosus (PDA) remains an important cardiovascular problem in term and pre-term infants. Consequent hemodynamically significant left-to-right shunt may impact all organ systems. There are several kinds of interventions to minimize adverse effects, including cyclooxygenase (COX) inhibitors, paracetamol, and surgical ligation. Surgical ligation is usually performed when medical th...

Left hemidiaphragm elevation is frequently noted following cardiac surgery employing topical hypothermia. We speculate that contact of the left phrenic nerve with ice causes nerve injury, resulting in left hemidiaphragm paresis or paralysis and left lower lobe atelectasis. Left diaphragm elevation was noted on postoperative chest x-ray examination of 36 of 60 (60 percent) consecutive patients i...

Phrenic nerve stimulation is often considered to be difficult and unreliable. The time taken for the phrenic nerves to be located and adequately stimulated was measured in 110 subjects, aged 21-89 years, 26 of whom had diaphragmatic weakness; and phrenic nerve conduction time was recorded in 76 of these individuals. Each phrenic nerve was stimulated transcutaneously in the neck with square wave...