Renal Sympathetic Denervation as Upstream Therapy During Atrial Fibrillation Ablation

Renal denervation for atrial fibrillation: a comprehensive updated systematic review and meta-analysis

“…Figure 1 is a PRISMA chart demonstrating the results of the literature search. Table 1 outlines the characteristics of the six included studies [ 17 – 22 ]. Table 2 summarizes the inclusion criteria, as well as the procedural methods employed by the studies.…”

“…The rate of AF recurrence was significantly lower across five trials in the RDN + PVI group [ 17 – 21 ]. Although the rates of AF recurrence were lower in the PVI + RDN groups of HFIB-1 and HFIB-2 trials, they failed to show a significant difference [ 22 ]. The overall pooled results of the recurrence of AF demonstrated a significantly lower rate of AF recurrence in the PVI + RDN (31.3%) group compared to the PVI-only (52.9%) group ( p < 0.00001) (Fig.…”

“…Five trials reported data on complications following the procedure and during the follow-up period in both the PVI + RDN group and the PVI alone groups [ 17 , 20 – 22 ], one reported complications only in the PVI + RDN group [ 18 ], and one study failed to specify the group in which the complications occurred and hence the rate could not be estimated for the PVI-alone group [ 19 ] (Table 5 ). HFIB-1 was excluded from the overall rates in both the RDN + PVI and PVI alone groups due to the early termination of study recruitment owing to a high rate of post-RDN renal vascular complications that might be attributed to the use of a non-FDA approved catheter [ 22 ]. The overall complication rate between the RDN + PVI and PVI alone group was 6.32% ( n = 316) and 11.8% ( n = 245) respectively.…”

Influence on the autonomic cardiovascular system regulation in the treatment of hypertension, arrhythmias and heart failure

“…Предлагалось выполнение ренальной денервации в дополнение к катетерной изоляции легочных вен, что в одноцентровых исследованиях было ассоциировано как со снижением АД у лиц с гипертензией, так и меньшей частотой возобновления ФП [68]. К сожалению, в недавнем многоцентровом исследовании показаны нейтральные результаты дополнительной ренальной денервации в лечении ФП [69].…”

Ablación y Neuromodulación en Tormenta Arrítmica. Serie de 4 casos y revisión de la literatura

“…Inicialmente los resultados fueron dispares, pero un mejor entendimiento de la anatomía nerviosa simpática peri renal ha permitido modificar la técnica y desarrollar mejor tecnología, con mejores resultados en los estudios clínicos actuales (SPYRAL HTN -ON -OFF MED) 33,34 . La DNR se está evaluando actualmente como una terapia adyuvante en un espectro de enfermedades cardiovasculares moduladas simpáticamente, que incluyen el metabolismo alterado de la glucosa, hipertrofia ventricular izquierda (HVI) y disfunción diastólica, insuficiencia cardíaca congestiva, apnea obstructiva del sueño, y fibrilación auricular 35,36 . Mediante un acceso endovascular arterial renal con un catéter específico de RF, se generan lesiones circunferenciales en forma de espiral para destruir las fibras simpáticas ubicadas en la grasa peri renal, principalmente cercano a la bifurcación arterial renal.…”