Document Detail


A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension.
MedLine Citation:
PMID:  22958958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this prospective randomized study was to assess the impact of renal artery denervation in patients with a history of refractory atrial fibrillation (AF) and drug-resistant hypertension who were referred for pulmonary vein isolation (PVI).
BACKGROUND: Hypertension is the most common cardiovascular condition responsible for the development and maintenance of AF. Treating drug-resistant hypertension with renal denervation has been reported to control blood pressure, but any effect on AF is unknown.
METHODS: Patients with a history of symptomatic paroxysmal or persistent AF refractory to ≥2 antiarrhythmic drugs and drug-resistant hypertension (systolic blood pressure >160 mm Hg despite triple drug therapy) were eligible for enrolment. Consenting patients were randomized to PVI only or PVI with renal artery denervation. All patients were followed ≥1 year to assess maintenance of sinus rhythm and to monitor changes in blood pressure.
RESULTS: Twenty-seven patients were enrolled, and 14 were randomized to PVI only, and 13 were randomized to PVI with renal artery denervation. At the end of the follow-up, significant reductions in systolic (from 181 ± 7 to 156 ± 5, p < 0.001) and diastolic blood pressure (from 97 ± 6 to 87 ± 4, p < 0.001) were observed in patients treated with PVI with renal denervation without significant change in the PVI only group. Nine of the 13 patients (69%) treated with PVI with renal denervation were AF-free at the 12-month post-ablation follow-up examination versus 4 (29%) of the 14 patients in the PVI-only group (p = 0.033).
CONCLUSIONS: Renal artery denervation reduces systolic and diastolic blood pressure in patients with drug-resistant hypertension and reduces AF recurrences when combined with PVI.
Authors:
Evgeny Pokushalov; Alexander Romanov; Giorgio Corbucci; Sergey Artyomenko; Vera Baranova; Alex Turov; Natalya Shirokova; Alexander Karaskov; Suneet Mittal; Jonathan S Steinberg
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2012-09-05
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-21     Completed Date:  2012-12-07     Revised Date:  2013-12-30    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1163-70     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01117025
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / complications,  surgery*
Blood Pressure / physiology
Catheter Ablation
Combined Modality Therapy
Denervation*
Double-Blind Method
Drug Resistance
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertension / complications,  physiopathology,  surgery*
Male
Middle Aged
Prospective Studies
Pulmonary Veins / surgery*
Recurrence
Renal Artery / innervation*,  surgery
Treatment Outcome
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2013 Nov 19;62(21):e445-6   [PMID:  24060455 ]
J Am Coll Cardiol. 2013 Nov 19;62(21):e446-9   [PMID:  24055846 ]
J Am Coll Cardiol. 2012 Sep 25;60(13):1171-2   [PMID:  22958955 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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