In February of 2003, I was a victim of a failed PVI ablation for atrial fibrillation. The doctor punctured the heart wall, which, in turn, caused a cardiac tamponade. I went into cardiac arrest, and was saved only when a surgeon was called in to cut my chest open in order to perform life saving techniques.
After the surgery, I continued to experience breathing problems. I finally went to a pulmonary doctor, and it was determined that I had a paralyzed right diaphragm. My PFT's were in the low 60% range, down from the low 90% range prior to the procedure. An EMG of the diaphragm was performed, but no evidence of phrenic nerve damage was found. I would assume, though, that the phrenic nerve is somehow involved with the paralysis.
This past March, further PFT's were done. I did show a slight improvement of about 5%, but breathing difficulties still persist. I am due for a second flouroscopy and more PFT's this month.
1). I have heard about a procedure called a diaphragmic plication, which can restore functions of the paralyzed diaphragm. Can you describe this procedure? How invasive is it? What is the success rate? Must improvement in the lung function reach a plateau before this procedure can be performed?
2) I get tired frequently. Most days I need to take a nap. Could it be that the paralyzed diaphragm is making me tired? My pulse/ox tests have always been excellent.
3) How does one find out what is actually causing the paralyzed diaphragm?
This is a very disturbing experience. The EMG of the diaphragm would have given information about the integrity of the diaphragm muscle, not the phrenic nerve. A nerve conduction study would have to be done to test the phrenic nerve to evaluate the cause of the paralysis. It is highly likely, as you suspect, that phrenic nerve damage is at the heart of your paralyzed right diaphragm.
Plication of the diaphragm has been successful in the treatment of paralysis. The success of the procedure would be directly related to the experience of the surgeon. If this proves to be your choice, you should get information on how many times the surgeon has done this procedure and his/her success rate. You might even want to speak with someone who's had it done. This surgery can be performed with minimal invasiveness.
Your fatigue might or might not be related to the paralysis. Your doctors should look for other causes.
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