title: Drug-resistant hypertensive patients responding to multielectrode renal denervation exhibit improved heart rate dynamics and reduced arrhythmia burden.
abstract: Transluminal renal sympathetic denervation (RDN) reduces blood pressure (BP) in patients with drug-resistant uncontrolled hypertension. We assessed the effect of RDN on heart rate, supraventricular and ventricular ectopic activity and indexes of heart rate variability in 14 patients with drug-resistant uncontrolled hypertension who were all responders to RDN (defined as a reduction in office systolic BP ⩾ 10 mm Hg) at baseline and at 1 and 6 months after the procedure using the multielectrode EnligHTN ablation catheter (St Jude Medical). Office and 24-h systolic and diastolic BP were significantly reduced both at 1 and 6 months after RDN and all patients were office BP responders. There was a trend toward office heart rate reduction (by 6.9 b.p.m., P=0.064) at 1 month and a significant reduction by 10 b.p.m. (P=0.004) at 6 months. Mean 24-h Holter monitoring heart rate was reduced by 6.7 b.p.m. (P=0.022) at 1 month and by 5.3 b.p.m. (P=0.010) at 6 months after RDN. The total number of premature supraventricular and ventricular contractions was significantly decreased and time- and frequency- domain indexes were increased both at 1 and at 6 months after RDN (P<0.05 for both cases). Apart from the substantial BP lowering, RDN results in significant reduction of mean heart rate and arrhythmia burden, restoring autonomic balance in responder patients with drug-resistant uncontrolled hypertension.
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Tsioufis
authors.affiliation: Veterans Affairs and Georgetown University Medical Centers, Washington, DC, USA.
authors.forename: V
authors.initials: V
authors.lastname: Papademetriou
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Tsiachris
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Dimitriadis
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kasiakogias
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kordalis
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Antonakis
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kefala
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Thomopoulos
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Kallikazaros
authors.affiliation: St Jude Medical, Irvine, CA, USA.
authors.forename: E O-Y
authors.initials: EO
authors.lastname: Lau
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000517:prevention & control*; D001794:Blood Pressure; D004351:Drug Resistance; D004566:Electrodes; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D013562:Sympathectomy / Q000379:methods*
chemical_list: D011188:Potassium