Clinical findings may include the immediate or delayed onset of:
(1) cough
(2) dyspnea
(3) hiccup
Imaging studies may show an elevation of the diaphragm on the affected side. This may be the only clue if the patient is clinically asymptomatic.
Injury to the right phrenic nerve occurs with treatment of:
(1) the right superior pulmonary vein
(2) superior vena cava disconnection
Injury to the left phrenic nerve occurs with:
(1) ablation of the left atrial appendage.
(2) lead implantation into the great cardiac and left obtuse marginal vein.
Sites susceptible to phrenic nerve injury tend to be relatively thin-walled.
In the study of Sacher et al, 66% had a complete recovery, 16.5% partial and 16.5% no recovery. Recovery may take up to a year or more.
