title: Adjunctive renal sympathetic denervation to modify hypertension as upstream therapy in the treatment of atrial fibrillation (H-FIB) study: clinical background and study design.
abstract: BACKGROUND
  Hypertension is the most important risk factor directly attributable to the high prevalence of atrial fibrillation (AF), and is one of the few modifiable risk factors for AF. Activation and overactivity of the sympathetic nervous system (SNS) have been implicated in the pathogenesis of both essential hypertension and AF. Catheter-based renal sympathetic denervation (RSDN) appears to be an effective adjunctive treatment for refractory hypertension, and may be beneficial in other conditions characterized by SNS overactivity, such as left ventricular hypertrophy and atrial arrhythmias.
  
  
  OBJECTIVE
  The H-FIB study is a multicenter prospective, double-blind, randomized (1:1) controlled trial. The primary efficacy endpoint is antiarrhythmic drug-free freedom from AF recurrence through 12 months.
  
  
  METHODS
  Patients with a history of significant hypertension who are receiving treatment with at least one antihypertensive agent who are planned for a first time ablation for symptomatic paroxysmal or persistent AF will be randomized to either AF ablation alone (control group) or AF ablation + RSDN (study group).
  
  
  CONCLUSIONS
  H-FIB is a multicenter, randomized trial that will test the hypothesis that adjunctive renal sympathetic denervation, at the time of AF ablation, will increase the freedom from recurrent AF.
authors: Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, New York 10029, USA.
authors: Humera
authors: H
authors: Ahmed
authors: Marc A
authors: MA
authors: Miller
authors: Srinivas R
authors: SR
authors: Dukkipati
authors: Sam
authors: S
authors: Cammack
authors: Jacob S
authors: JS
authors: Koruth
authors: Sandeep
authors: S
authors: Gangireddy
authors: Betsy A
authors: BA
authors: Ellsworth
authors: Andre
authors: A
authors: D'Avila
authors: Michael
authors: M
authors: Domanski
authors: Annetine C
authors: AC
authors: Gelijns
authors: Alan
authors: A
authors: Moskowitz
authors: Vivek Y
authors: VY
authors: Reddy
mesh_terms: D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D017115:Catheter Ablation / Q000379:methods*; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D011667:Pulmonary Veins / Q000601:surgery; D011859:Radiography; D012008:Recurrence; D012077:Renal Artery / Q000000981:diagnostic imaging; D012307:Risk Factors; D013562:Sympathectomy / Q000379:methods; D013564:Sympathetic Nervous System / Q000601:surgery*