title: Cardiorenal axis and arrhythmias: Will renal sympathetic denervation provide additive value to the therapeutic arsenal?
abstract: Disruption of sympathetic tone may result in the occurrence or maintenance of cardiac arrhythmias. Multiple arrhythmic therapies that intervene by influencing cardiac sympathetic tone are common in clinical practice. These vary from pharmaceutical (β-blockers, angiotensin-converting enzyme inhibitors, and calcium antagonists) to percutaneous/surgical (cardiac sympathetic denervation) interventions. In some patients, however, these therapies have insufficient prophylactic and therapeutic capabilities. A safe and effective additional therapy wherein sympathetic drive is further attenuated would be expedient. Recently, renal sympathetic denervation (RSD) has been subject of research for various sympathetic nervous system-related diseases. By its presumed afferent and efferent sympatholytic effects, RSD might indirectly attenuate sympathetic outflow via the brain to the heart but might also reduce systemic catecholamine excretion and might therefore reduce catecholamine-sensitive arrhythmias. RSD is subject of research for various sympathetically driven arrhythmias, both supraventricular and ventricular. In this review, we give an overview of the rationale behind RSD as potential therapy in mediating arrhythmias that are triggered by a disrupted sympathetic nervous system and discuss the presently available results from animal and human studies.
authors: Heart Centre, Department of Clinical and Experimental Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Peter M
authors: PM
authors: van Brussel
authors: Heart Centre, Department of Clinical and Experimental Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Krystien V V
authors: KV
authors: Lieve
authors: Heart Centre, Department of Clinical and Experimental Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Robbert J
authors: RJ
authors: de Winter
authors: Heart Centre, Department of Clinical and Experimental Cardiology, Academic Medical Centre, Amsterdam, The Netherlands; Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia. Electronic address: a.a.wilde@amc.uva.nl.
authors: Arthur A M
authors: AA
authors: Wilde
mesh_terms: D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000294:innervation*; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome
keywords: Atrial fibrillation; Renal sympathetic denervation; Supraventricular arrhythmia; Ventricular arrhythmia