title: The need for and the challenges of measuring renal sympathetic nerve activity.
abstract: Renal denervation (RDN) was primarily developed to treat hypertension and is potentially a new method for treating arrhythmias. Because of the lack of a standardized protocol to measure renal sympathetic nerve activity, RDN is administered in a blind manner. This inability to assess efficacy at the time of treatment delivery may be a large contributor to the ambiguity of RDN outcomes reported in the hypertension literature. The advancement of RDN as a treatment of hypertension or arrhythmias will be hampered by the lack of delivery assessment, a deficiency that the cardiovascular electrophysiology community, with its expertise in recording and mapping, may have a role in addressing and overcoming. The development of endovascular recording of renal nerve action potentials may provide a useful accessory tool for RDN. Innovation in this area will be crucial as we as a community reconsider the therapeutic value of RDN.
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Govind Krishna Kumar
authors.initials: GKK
authors.lastname: Nair
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Massé
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Asta
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Elias
authors.initials: E
authors.lastname: Sevaptisidis
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Mohammed Ali
authors.initials: MA
authors.lastname: Azam
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Patrick F H
authors.initials: PFH
authors.lastname: Lai
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Arul
authors.initials: A
authors.lastname: Veluppillaim
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Karl
authors.initials: K
authors.lastname: Magtibay
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Jackson
authors.affiliation: University Health Network, Toronto, Ontario, Canada. Electronic address: kumar.nanthakumar@uhn.ca.
authors.forename: Kumaraswamy
authors.initials: K
authors.lastname: Nanthakumar
mesh_terms: D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy; D007668:Kidney / Q000294:innervation; D017063:Outcome Assessment, Health Care; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D016896:Treatment Outcome
keywords: Cardiac arrhythmia; Hypertension; Neural recording; Renal denervation; Sympathetic nerve activity