Hello all, i’m 1 week post 2nd ablation for PAF at the new Royal Papworth Hospital and have just had a bit of bad news. Following a lot of chest pain and breathing difficulty and a trip to A and E i’ve been told I have phrenic nerve damage possibly from the procedure last week. Once the procedure was done last week and I woke up in recovery I must admit I did feel different to last time, much more achey and sore than I did the first time and now I know the reason why. Does anybody else have any experience of recovery from this issue?
Thanks
Matt
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Matt40
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Not personally but others here have Seacrh phrenic nerve damage (box top right) and you will find posts. I understand it may take considerable time to recover depending on how bad it is.
I had phrenic nerve damage after procedure in 2017, it has fully recovered now, recovery took a good nine months.Be patient give it time, i am led to believe it can take anything from weeks to two years for full recovery. My best wishes for a speedy recovery for you.
It would be interesting to know the experience of the person who carried out the ablation (EP or registrar) and whether this was RF or cryo. Phrenic nerve damage is avoidable.
Hello there - it was RF and the EP who did the work has been doing it for 15 years. He doesn’t think it is Phrenic nerve damage but he hasn’t looked at anything to establish it, only spoke to me on the phone. I went to A and E as I really couldn’t breathe and they did bloods and a chest X-ray which showed the raised diaphragm on the right hand side, coming up and pushing on my lung and then was told it could be that or possible partially collapsed lung/pneumonia?? Was then given antibiotics and sent home. Antibiotics have done nothing, still have same symptoms and EP not really interested.
I'm sorry to hear that. Phrenic nerve palsy is usually caused by using a cryo balloon on a PV that's too wide so the balloon goes in too far. It should be possible to get a definite diagnosis using fluoroscopy, see:
Did the EP actually do it himself or did he get one of his underlings? If the antibiotics don't work in a few days, I would ask for a definite diagnosis.
When I had my cryoablation my EP 'excited' my diaphragm in the op as he said this was a way to monitor potential phrenic nerve damage during the procedure.
He said it would be like hiccups but it was much more violent than that, even in my doped state. I don't know whether this is a common technique or something my EP has developed from his own experience. He told me that one of the pulmonary veins was very close to the phrenic nerve hence his precaution. It worked in the sense that there was no phrenic issues.
I have personally had your experience. Weeks after my Five Box Totally Thoracoscopic Maze Procedure performed by the Pioneer of this procedure, I could not walk 5 feet without giving completely out of breath. Prior to the procedure, I was walking at least five miles per day, briskly with no problems. I had to have a wheel chair to get from my car into the Dr's office. I was immediately admitted to the hospital for tests, as they suspected a blood clot in my lungs, which made sense because after these procedures you are always at a high risk for blood clots. After many, many tests about 7 Dr's from the Medical Team came into my room and surrounded me with the bad news of a Paralyzed Diaphragm, which is caused by damaged Phrenic Nerve. I was devastated, would have rather had the blood clot, they can dissolve that! I would have rather had Afib! The Maze, although not open-heart, is not a walk in the park and now this!
Since, I traveled hundreds of miles to this phenomenal surgeon, I was corresponding via text and emails. I gave him the news and he was very confident that this was not the case, as he is quite aware of the phrenic nerve during all his procedures. After all, he is a Cardiothoracic Surgeon (Cardio-heart, Thoracic-lungs). He told me that my diaphragm would come back, as that he was certain that it had nothing to do with any kind of damage from the surgery, and that it could take up to a year. I really wanted to believe what he was saying - that the diaphragm was in shock (some call it frozen). So, I started seeing a Pulmonolgist every 3 months. And, lo and behold, after exactly one year, my diaphragm was back!! So, please make sure you see a Pulmonologist and get the necessary tests and xrays to see the progress. Hang in there!
p. s. Mine was exactly like yours, elevated right diaphragm. I saw the xrays and it looked wicked! Also, I see where Flutter-1 talks about the hiccups. I did not hiccup for almost a year - diaphragm muscle is served by the phrenic nerve. You have never seen someone so excited to hiccup! lol! I knew I was on my way to recovery!
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Phrenic nerve palsy after ablation.
Ablation of the nerve endings of the heart ,(ganglionated plexi)
