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Renal denervation for treatment of ventricular arrhythmias: data from an International Multicenter Registry

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Abstract

Introduction

Ventricular arrhythmias (VAs) in patients with chronic heart failure (CHF) are sometimes refractory to antiarrhythmic drugs and cardiac ablation. This study aimed to investigate catheter-based renal sympathetic denervation (RDN) as antiarrhythmic strategy in refractory VA.

Methods

These are the first data from a pooled analysis of 13 cases from five large international centers (age 59.2 ± 14.4 years, all male) with CHF (ejection fraction 25.8 ± 10.1 %, NYHA class 2.6 ± 1) presented with refractory VA who underwent RDN. Ventricular arrhythmias, ICD therapies, clinical status, and blood pressure (BP) were evaluated before and 1–12 months after RDN.

Results

Within 4 weeks prior RDN, a median of 21 (interquartile range 10–30) ventricular tachycardia (VT) or fibrillation (VF) episodes occurred despite antiarrhythmic drugs and prior cardiac ablation. RDN was performed bilaterally with a total number of 12.5 ± 3.5 ablations and without peri-procedural complications. One and 3 months after RDN, VT/VF episodes were reduced to 2 (0–7) (p = 0.004) and 0 (p = 0.006), respectively. Four (31 %) and 11 (85 %) patients of these 13 patients were free from VA at 1 and 3 months. Although BP was low at baseline (116 ± 18/73 ± 13 mmHg), no significant changes of BP or NYHA class were observed after RDN. During follow-up, three patients died from non-rhythm-related causes.

Conclusions

In patients with CHF and refractory VA, RDN appears to be safe concerning peri-procedural complications and blood pressure changes, and is associated with a reduced arrhythmic burden.

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Authors and Affiliations

  1. Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Kirrberger Str. 1, 66421, Homburg, Saar, Germany

    Christian Ukena, Felix Mahfoud, Sebastian Ewen, Dominik Linz, Valerie Pavlicek & Michael Böhm

  2. Abteilung für Rhythmologie, Klinik für Innere Medizin/Kardiologie, Herzzentrum Leipzig, Leipzig, Germany

    Andreas Bollmann & Gerhard Hindricks

  3. Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

    Boris A. Hoffmann & Stephan Willems

  4. Arrhythmia Institute, Valley Health System, University of Rochester School of Medicine and Dentistry, New York, NY, USA

    Dan Musat & Jonathan S. Steinberg

  5. Innere Medizin III (Kardiologie, Angiologie, Pneumologie), Universitätsklinikum Heidelberg, Heidelberg, Germany

    Eberhard Scholz & Dierk Thomas

Authors
  1. Christian Ukena
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  2. Felix Mahfoud
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  3. Sebastian Ewen
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  4. Andreas Bollmann
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  6. Boris A. Hoffmann
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  7. Dominik Linz
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  8. Dan Musat
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  11. Dierk Thomas
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  12. Stephan Willems
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  13. Michael Böhm
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  14. Jonathan S. Steinberg
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Corresponding author

Correspondence to Christian Ukena.

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Conflict of interest

CU, FM, and MB are supported by the Ministry of Science and Economy of the Saarland. FM and DL are supported by the Deutsche Hochdruckliga. CU and MB are supported by the Deutsche Forschungsgemeinschaft (KFO 196). FM, DL and MB are supported by Deutsche Gesellschaft für Kardiologie. CU, FM, and MB received scientific support and speaker honorarium from Medtronic Inc. and St. Jude Medical. DT was supported by the DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung—German Center for Cardiovascular Research) and the BMBF (German Ministry of Education and Research). JSS has served as consultant to Medtronic, Boston Scientific and Biosense Webster, and has received research support from Medtronic and Biosense Webster.

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Ukena, C., Mahfoud, F., Ewen, S. et al. Renal denervation for treatment of ventricular arrhythmias: data from an International Multicenter Registry. Clin Res Cardiol 105, 873–879 (2016). https://doi.org/10.1007/s00392-016-1012-y

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  • DOI: https://doi.org/10.1007/s00392-016-1012-y

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