title: Renal denervation for improving outcomes of catheter ablation in patients with atrial fibrillation and hypertension: early experience.
abstract: BACKGROUND
  The potential role of renal denervation (RD) in patients with AF and less severe hypertension is unknown.
  
  
  OBJECTIVE
  The purpose of this study was to assess the potential role of RD as an adjunct to pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) and moderate resistant or severe resistant hypertension.
  
  
  METHODS
  The data for this study were obtained from 2 different prospective randomized studies, analyzed by meta-analysis. Patients with paroxysmal AF or persistent AF and moderate resistant hypertension (office blood pressure BP ≥140/90 mm Hg and <160/100 mm Hg; first study; n = 48) or severe resistant hypertension (≥160/100 mm Hg; second study; n = 38) were randomized to PVI or PVI with RD.
  
  
  RESULTS
  At 12 months, 26 of the 41 PVI with RD patients (63%) were AF-free vs 16 of the 39 patients (41%) in the PVI-only group (P = .014). In patients with severe hypertension, 11 of the 18 PVI with RD patients (61%) vs 5 of the 18 PVI-only patients (28%) were AF-free (P = .03). For moderate hypertension, the differences were less dramatic: 11 of 21 (52%) vs 15 of 23 (65%) when RD added (P = .19). The superior efficacy of adding RD was most apparent in persistent AF and severe hypertension (hazard ratio 0.25, confidence interval 0.09-0.72, P = .01). Duration of the procedure and fluoroscopy were nonsignificantly longer in the RD group.
  
  
  CONCLUSIONS
  RD may improve the results of PVI in patients with persistent AF and/or severe resistant hypertension.
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia. Electronic address: E.Pokushalov@gmail.com.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Pokushalov
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Romanov
authors.affiliation: Department of Cardiology, Athens Euroclinic, Athens, Greece.
authors.forename: Demosthenes G
authors.initials: DG
authors.lastname: Katritsis
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Sergey
authors.initials: S
authors.lastname: Artyomenko
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Sevda
authors.initials: S
authors.lastname: Bayramova
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Denis
authors.initials: D
authors.lastname: Losik
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Vera
authors.initials: V
authors.lastname: Baranova
authors.affiliation: State Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Karaskov
authors.affiliation: The Valley Health System, New York, New York, and Ridgewood, New Jersey.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Steinberg
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D001794:Blood Pressure; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D012077:Renal Artery / Q000294:innervation*; D016019:Survival Analysis; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013564:Sympathetic Nervous System / Q000502:physiology; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Renal denervation; Resistant hypertension