Author + information
- Konstantinos P. Tsioufis,
- Vasilios Papademetriou,
- Dimitrios Tsiachris,
- Kyriakos Dimitriadis,
- Costas Thomopoulos,
- Anna Kefala,
- Velissarios Antonakis,
- Dimitrios Tousoulis,
- Ioannis Kallikazaros and
- Christodoulos Stefanadis
Transluminal renal sympathetic denervation (RSD) reduces blood pressure (BP) in patients with treatment-resistant hypertension. We assessed the effect of RSD on heart rate and cardiac arrhythmias in patients with resistant hypertension.
Fourteen patients with resistant hypertension underwent ambulatory BP measurements and Holter monitoring at baseline and 1 month after RSD using the EnligHTN ablation catheter (St. Jude Medical, CA, USA). Patients with grade II and above of the Lown-Wolf classification were considered to have complex ventricular arrhythmias while the presence of ≥3 consecutive premature supraventricular contractions was defined as paroxysmal atrial fibrillation (PAF).
One month post RNA, office and 24-hour BP was significantly reduced by 38/14.1 mmHg, p<0.001/0.003 and 18/9.5 mmHg, p<0.001/0.001, respectively). Office, ambulatory and average 24-hour heart rate were significantly reduced by 7 bpm, (p=0.046), 5.5 bpm and 6.7 bpm (p=0.022), respectively. Complex ventricular arrhythmias were present in 5 out of 14 patients with resistant hypertension (1 with non sustained ventricular tachycardia and 4 with ventricular couplets) at baseline but persisted only in 2 of them one month after RSD (2 patients with ventricular couplets). The number of premature ventricular contractions was significantly decreased after RSD (from 2.23/hour to 0.39/hour, p=0.019). Episodes of PAF were detected in 5 of 14 subjects at baseline and in 2 of those patients one month after RSD. The total number of premature supraventricular contractions was also significantly decreased after RSD from 1.62/hour to 0.72/hour (p=0.039). There was no relationship between the observed difference in premature supraventricular and ventricular contractions after RSD and the drop in office and 24hour BP.
RSD significantly reduces office and ambulatory BP and heart rate and exerts a favorable effect on atrial and ventricular arrhythmias in resistant hypertensives, supporting the concept of the “pleotropic” effects of RSD beyond the BP reduction in this setting.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Renal Denervation: Coming of Age
Abstract Category: 25. Prevention: Hypertension
Presentation Number: 1148-22
- 2013 American College of Cardiology Foundation