title: Renal sympathetic denervation therapy in the real world: results from the Heidelberg registry.
abstract: BACKGROUND
  Renal sympathetic denervation (RDN) is a novel treatment option in patients with treatment-resistant arterial hypertension. A subset of recently published randomized and non-randomized trials indicates that RDN leads to sustained lowering of blood pressure (BP) under controlled study conditions. However, registry data that allow evaluation of safety and efficacy in a real-world setting are largely missing.
  
  
  METHODS
  Sixty-three consecutive patients with treatment-resistant hypertension underwent RDN with the radiofrequency-based Symplicity™ catheter. As part of our prospective registry, treatment efficacy and safety were monitored after 3, 6, and 12 months.
  
  
  RESULTS
  At 6 months follow-up, office systolic BP significantly improved by 19 + 23 mmHg as compared to baseline, while diastolic BP values reduced by 6 + 13 mmHg (p < 0.05). One year after RDN, office BP levels further improved (26 + 25 mmHg in systolic BP and 9 + 13 mmHg in diastolic BP, respectively), even though 19 patients had reduced the number and/or dosage of antihypertensive agents. The response rate, defined as reduction of office systolic BP of ≥ 10 mmHg, was 73% after 6 months. Baseline BP was the only significant predictor of blood pressure response, whereas no correlation was found between the number of ablation points and the individual changes in office blood pressure. Interestingly, patients with challenging renal anatomy profited somewhat less from the procedure than those with "normal" renal anatomy. Procedure related adverse events occurred in three patients (4.7%) and were limited to vascular access complications.
  
  
  CONCLUSIONS
  RDN with the Symplicity™ system is safe and effective in patients with treatment-resistant hypertension also in a real-world setting.
authors.affiliation: Medical Clinic III, University of Heidelberg, INF 410, 69120, Heidelberg, Germany, britta.vogel@med.uni-heidelberg.de.
authors.forename: Britta
authors.initials: B
authors.lastname: Vogel
authors.forename: Michael
authors.initials: M
authors.lastname: Kirchberger
authors.forename: Martin
authors.initials: M
authors.lastname: Zeier
authors.forename: Felicitas
authors.initials: F
authors.lastname: Stoll
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meder
authors.forename: Daniel
authors.initials: D
authors.lastname: Saure
authors.forename: Martin
authors.initials: M
authors.lastname: Andrassy
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Mueller
authors.forename: Stefan
authors.initials: S
authors.lastname: Hardt
authors.forename: Vedat
authors.initials: V
authors.lastname: Schwenger
authors.forename: Anna
authors.initials: A
authors.lastname: Strothmeyer
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Erwin
authors.initials: E
authors.lastname: Blessing
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation; D004351:Drug Resistance; D005260:Female; D005858:Germany; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012077:Renal Artery / Q000294:innervation / Q000601:surgery*; D013562:Sympathectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices
chemical_list: D000959:Antihypertensive Agents