Results of the ALSTER BP real-world registry on renal denervation employing the Symplicity system.
OBJECTIVE
To prove the efficacy and safety of renal sympathetic denervation as a new treatment option for patients suffering from resistant hypertension in a real-world setting.


RESULTS
This single-centre real-world registry included 93 patients who underwent renal denervation employing the Symplicity system. Patients were followed for six months. The patient cohort was divided into early responders with a reduction of office systolic blood pressure >10 mmHg three months after the procedure (n=53, 57%), late responders (six months after the procedure, n=16, 17%) and non-responders (n=24, 26%). After six months, systolic blood pressure was lowered by 46±2.9 mmHg (mean±SEM, p<0.001), 31±3.4 mmHg (p<0.001) and 7.1±3.3 mmHg (p=0.79, ns), respectively. Ambulatory blood pressure monitoring also showed a significant reduction in the early responder group (20±5.7 mmHg, p=0.002). We subjected eight patients to a re-do procedure which led to a significant reduction of blood pressure in another five patients after six months (63%). One patient in this cohort developed a one-sided renal artery stenosis associated with an increase in blood pressure.


CONCLUSIONS
This real-world analysis of renal sympathetic denervation confirms the procedure to be safe and efficient in the majority of patients. Non-responders may profit from a second ablation, arguing in favour of the hypothesis that the procedure did not destroy sufficient amounts of sympathetic innervation in these patients. However, repeated denervations may also increase side effects.
Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
Lukas
L
Kaiser
Thomas
T
Beister
Andrea
A
Wiese
Jasper
J
von Wedel
Felix
F
Meincke
Felix
F
Kreidel
Andreas
A
Busjahn
Karl-Heinz
KH
Kuck
Martin W
MW
Bergmann
D000368:Aged; D001794:Blood Pressure; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D007668:Kidney / Q000294:innervation; D008297:Male; D008875:Middle Aged; D012042:Registries; D012077:Renal Artery / Q000294:innervation / Q000601:surgery*; D013562:Sympathectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome