Renal sympathetic denervation: a 'remote control' for atrial fibrillation therapy.

Abstract

This editorial refers to ‘Effect of renal sympathetic denervation on the progression of paroxysmal atrial fibrillation in canines with long-term intermittent atrial pacing’ by X. Wang et al. , on page 647–654. Pulmonary vein isolation is a commonly used ablation approach to treat patients with paroxysmal atrial fibrillation (AF). While short-term effects after a single procedure look promising, the picture is less optimistic in the long-term, with a 5-year arrhythmia-free survival rate of ∼30% after a single procedure and <40% of patients are off antiarrhythmic drugs.1,2 Autonomic influences are prominently involved in the pathophysiology of AF.3 Changes in the autonomic tone have been observed prior to the onset of paroxysmal AF, and both sympathetic and parasympathetic influences may act in a pro-arrhythmic fashion leading to initiation of the …