Abstract
Pokushalov et al (J Am Coll Cardiol 2012;60:1163–1170, PMID 22958958) evaluated renal artery denervation in patients with refractory atrial fibrillation (AF) and drug-resistant hypertension referred for pulmonary vein isolation (PVI) in a prospective randomized study. Patients with AF refractory to ≥2 antiarrhythmic drugs and drug-resistant hypertension (systolic blood pressure >160 mm Hg despite triple drug therapy) were randomized to PVI only or PVI with renal artery denervation and followed for ≥1 year. Twenty-seven patients were enrolled, including 14 randomized to PVI only and 13 to PVI with renal artery denervation. Significant reductions in systolic (181 ± 7 to 156 ± 5; P <.001) and diastolic (97 ± 6 to 87 ± 4; P <.001) blood pressure were observed in patients treated with PVI with renal denervation without significant change in the PVI-only group. Nine of the 13 (69%) patients treated with PVI with renal denervation were AF-free at 12 months vs 4 of 14 (29%) patients in the PVI-only group (P = .033). The authors conclude that renal artery denervation reduces systolic and diastolic blood pressure in patients with drug-resistant hypertension and reduces AF recurrences when combined with PVI.
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