Phrenic Nerve Injury During Ablation of Atrial Fibrillation: Mechanisms, Clinical Features, Prognosis, and Prevention Methods

Atrial fibrillation ablation procedures have become a focus of research among electrophysiologists, with the aim of increasing success rates while minimizing complications. One major concern is phrenic nerve injury (PNI). Despite advancements in ablation strategies, equipment, and monitoring methods, the incidence of PNI during these procedures remains substantial, particularly during cryoballoon ablation, which has a reported PNI incidence of 3.5%. This review examines recent studies, to provide a comprehensive overview of PNI mechanisms, clinical features, prognosis, and methods for prevention during ablation.