BACKGROUND Traumatic pericardial rupture is a rare presentation. Pericardial rupture itself is asymptomatic unless complicated by either hemorrhage or herniation of the heart through the defect. Following diagnosis surgical repair of the pericardium is indicated because cardiac herniation may result in vascular collapse and sudden death. OBJECTIVES Here we present a case of traumatic, non-her...

Introduction Phrenic nerve injury is a recognized complication of catheter ablation procedures for atrial and ventricular arrhythmias. The posterolateral right atrium (RA) is a common site of origin for atrial tachycardias (AT), but ablation in this region can be hazardous because of the proximity of the right phrenic nerve (RPN). Proximity to the nerve may be identified by capture during pacin...

OBJECTIVE Computer (robotic) enhancement has been used to facilitate simple thoracoscopic procedures such as internal mammary artery (IMA) mobilization. This report describes the use of robotic technology in advanced thoracoscopic procedures. METHODS Ten patients underwent advanced thoracoscopic procedures utilizing the Da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA) ...

OBJECTIVE Constrictive pericarditis is a disease characterized by marked thickening of the pericardium which causes restriction of diastolic cardiac function. The purpose of this report is to review the outcome of pericardiectomy for constrictive pericarditis and to discuss its problems. METHODS Sixteen consecutive patients who underwent pericardiectomy for constrictive pericarditis in our in...

Radiofrequency ablation is increasingly used as an option to optimally manage patients with symptomatic atrial fibrillation. Presently, ablationists strive to improve success rates, particularly with persistent atrial fibrillation, while simultaneously attempting to reduce complications. A well-recognized complication with atrial fibrillation ablation is injury to the phrenic nerve giving rise ...

BACKGROUND One of the major limitations of left ventricular pacing is phrenic nerve stimulation. OBJECTIVE We evaluated the characteristics of the strength-duration curves of the left phrenic nerve (PN) and epicardium of the left ventricle (LV). METHODS A total of 12 mongrel dogs were studied. Capture threshold was assessed during pacing with 180 beats/min and various pulse durations (0.25 ...

The transdiaphragmatic pressure (Pdi) generated during bilateral supramaximal phrenic nerve stimulation at 1 Hz from surface stimulating electrodes was compared with pressures obtained from needle electrodes inserted under local anaesthesia. Surface electrodes were used to obtain diaphragmatic electromyograms and magnetometers to monitor rib cage and abdominal configuration. Twitch Pdi was reco...

BACKGROUND Electromyography-guided phrenic nerve (PN) monitoring using a catheter positioned in a hepatic vein can aid in preventing phrenic nerve palsy (PNP) during cryoballoon ablation for atrial fibrillation. We wanted to evaluate the feasibility and efficacy of PN monitoring during procedures using second-generation cryoballoons. METHODS AND RESULTS This study included 140 patients (43 wo...