title: Renal sympathetic denervation for treatment of electrical storm: first-in-man experience.
abstract: BACKGROUND
  Sympathetic activity plays an important role in the pathogenesis of ventricular tachyarrhythmia. Catheter-based renal sympathetic denervation (RDN) is a novel treatment option for patients with resistant hypertension, proved to reduce local and whole-body sympathetic activity.
  
  
  METHODS
  Two patients with chronic heart failure (CHF) (non-obstructive hypertrophic and dilated cardiomyopathy, NYHA III) suffering from therapy resistant electrical storm underwent therapeutic renal denervation. In both patients, RDN was conducted with agreement of the local ethics committee and after obtaining informed consent.
  
  
  RESULTS
  The patient with hypertrophic cardiomyopathy had recurrent monomorphic ventricular tachycardia despite extensive antiarrhythmic therapy, following repeated endocardial and epicardial electrophysiological ablation attempts to destroy an arrhythmogenic intramural focus in the left ventricle. The second patient, with dilated nonischemic cardiomyopathy, suffered from recurrent episodes of polymorphic ventricular tachycardia and ventricular fibrillation. The patient declined catheter ablation of these tachycardias. In both patients, RDN was performed without procedure-related complications. Following RDN, ventricular tachyarrhythmias were significantly reduced in both patients. Blood pressure and clinical status remained stable during the procedure and follow-up in these patients with CHF.
  
  
  CONCLUSIONS
  Our findings suggest that RDN is feasible even in cardiac unstable patients. Randomized controlled trials are urgently needed to study the effects of RD in patients with electrical storm and CHF.
authors.affiliation: Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Kirrberger Str. 1, 66421 Homburg/Saar, Germany. Christian.Ukena@uks.eu
authors.forename: Christian
authors.initials: C
authors.lastname: Ukena
authors.forename: Axel
authors.initials: A
authors.lastname: Bauer
authors.forename: Felix
authors.initials: F
authors.lastname: Mahfoud
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schreieck
authors.forename: Hans-Ruprecht
authors.initials: HR
authors.lastname: Neuberger
authors.forename: Christian
authors.initials: C
authors.lastname: Eick
authors.forename: Paul A
authors.initials: PA
authors.lastname: Sobotka
authors.forename: Meinrad
authors.initials: M
authors.lastname: Gawaz
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D002908:Chronic Disease; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013562:Sympathectomy / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome