title: Renal sympathetic denervation using an externally irrigated radiofrequency ablation catheter for treatment of resistant hypertension - Acute safety and short term efficacy.
abstract: OBJECTIVE
  This study was conducted to assess the acute safety and short term efficacy of renal sympathetic denervation (RSDN) using solid tip radiofrequency ablation (RFA) catheter and saline irrigation through the renal guiding catheter to achieve effective denervation.
  
  
  BACKGROUND
  RSDN using a specialized solid-tip RFA catheter has recently been demonstrated to safely reduce systemic blood pressure in patients with refractory hypertension, the limitation being inadequate power delivery in renal arteries. So, we used solid-tip RFA catheter along with saline irrigation for RSDN.
  
  
  METHODS
  Nine patients with resistant hypertension underwent CT and conventional renal angiography, followed by bilateral or unilateral RSDN using 5F RFA catheter with saline irrigation through renal guiding catheter. Repeat renal angiography was performed at the end of the procedure. In all patients, pre- and post-procedure serum creatinine was measured.
  
  
  RESULTS
  Over 1-month period: 1) the systolic/diastolic blood pressure decreased by -57 ± 20/-25 ± 7.5 mm Hg; 2) all patients experienced a decrease in systolic blood pressure of at least -36 mm Hg (range 36-98 mm Hg); 3) there was no evidence of renal artery injury immediate post-procedure. There was no significant change in serum creatinine level.
  
  
  CONCLUSIONS
  This data shows the acute procedural safety and short term efficacy of RSDN using modified externally irrigated solid tip RFA catheter.
authors.affiliation: Fellow in Cardiac Electrophysiology, Narayana Hrudayalaya, Bangalore, India. Electronic address: pedssachin@gmail.com.
authors.forename: Sachin
authors.initials: S
authors.lastname: Yalagudri
authors.affiliation: Senior Resident, Dept of Cardiology, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Narayana
authors.initials: N
authors.lastname: Raju
authors.affiliation: Fellow in Cardiac Electrophysiology, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Bharati
authors.initials: B
authors.lastname: Das
authors.affiliation: Consultant Cardiologist, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Daware
authors.affiliation: Consultant Paediatric Cardiologist and Electrophysiologist, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Shreesha
authors.initials: S
authors.lastname: Maiya
authors.affiliation: Senior Consultant Cardiologist and Electrophysiologist, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Kannan
authors.initials: K
authors.lastname: Jothiraj
authors.affiliation: Head of Electrophysiology and Arrhythmia Services, Narayana Hrudayalaya, Bangalore, India.
authors.forename: A G
authors.initials: AG
authors.lastname: Ravikishore
mesh_terms: D015901:Angiography, Digital Subtraction; D001794:Blood Pressure / Q000502:physiology*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012077:Renal Artery / Q000294:innervation*; D012449:Safety; D013562:Sympathectomy / Q000379:methods*; D007507:Therapeutic Irrigation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
keywords: Modified saline irrigated ablation catheter; Renal denervation; Resistant hypertension