title: Catheter-based renal denervation for drug-resistant hypertension by using a standard electrophysiology catheter.
abstract: OBJECTIVE
  The endovascular application of low-dose radiofrequency (RF) energy to the renal arteries results in effective ablation of sympathetic nerve fibres leading to a significant lowering of blood pressure (BP). This study aims to examine the feasibility and safety of renal denervation by the use of a standard electrophysiology (EP) catheter.
  
  
  RESULTS
  Twelve patients (mean age 62±14 years, nine male) with drug resistant hypertension despite medical treatment with at least four antihypertensive drugs underwent renal denervation by using a standard steerable RF ablation catheter with a 7 Fr diameter (Marinr®; Medtronic Inc., Minneapolis, MN, USA). Low-power RF applications have been applied along the length of both renal arteries, consecutively. Assessment of 24 hour ambulatory BP was done at baseline, at one, and at three months following RF ablation. The mean reduction of 24 hour ambulatory BP was -11/-7 mmHg at one month and -24/-14 mmHg at three months (p<0.01 for systolic and p<0.03 for diastolic blood pressure) with unchanged medication. No vascular complications have been observed in the short-term follow-up. The renal function as assessed by serum creatinine and proteinuria remained unchanged from baseline.
  
  
  CONCLUSIONS
  Our preliminary results indicate that the use of a standard RF ablation catheter is feasible and safe for sympathetic renal denervation as shown by a significant lowering of mean 24 hour ambulatory BP in comparison to baseline during short-term follow-up. Whether the use of a standard EP catheter for sympathetic renal denervation indeed improves the long-term outcome in resistant hypertension, however, remains to be investigated.
authors.affiliation: Department of Internal Medicine I, Friedrich Schiller University, Jena, Germany. dirk.prochnau@med.uni-jena.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Prochnau
authors.forename: Norma
authors.initials: N
authors.lastname: Lucas
authors.forename: Helmut
authors.initials: H
authors.lastname: Kuehnert
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
authors.forename: Ralf
authors.initials: R
authors.lastname: Surber
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D003404:Creatinine / Q000097:blood; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000294:innervation*; D012189:Retrospective Studies; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D003404:Creatinine