A new clinical trial is now underway at the Massachusetts General Hospital, Boston, USA, to investigate whether combining pulmonary vein isolation and renal denervation will improve the long-term outcome in the treatment of atrial fibrillation. On 17 June, Mass General physicians used the combined techniques to treat a 60-year-old patient with chronic heart disease.
According to a Mass General press release, this is the first hospital in New England -and the second in the USA-to pair renal artery sympathetic denervation with pulmonary vein isolation for patients with atrial fibrillation and hypertension.
“Typically these procedures are done separately,” said Moussa Mansour, director of the Atrial Fibrillation Program in the Mass General Institute for Heart, Vascular and Stroke Care. “In this trial, renal denervation is not only performed to treat the patient’s hypertension, which is the usual goal of the procedure, but as an adjunct to pulmonary vein isolation to improve the outcome of atrial fibrillation ablation. We see real potential in this treatment for patients who continue to experience atrial fibrillation symptoms in spite of medical treatment as well as for those who cannot tolerate antiarrhythmic drugs. Atrial fibrillation affects more than three million people in the USAand is a major cause of stroke.”
“This procedure capitalises on the strengths of the electrophysiologists in the use of ablation catheters, and the vascular medicine physician in the imaging of the renal arteries and associate interventions in this locale,” said Joseph Garasic, director of Peripheral Vascular Intervention in the Cardiology Division, Institute for Heart, Vascular and Stroke Care. “It also marks the first time we have performed the renal denervation procedure at Mass General. Increasing evidence has shown that this procedure may have even more far-reaching benefits in the treatment of other diseases beyond uncontrolled hypertension, including heart failure, sleep apnea and cardiac arrhythmias.”
The patient will now continue to be evaluated on a regular basis to study the procedure’s effectiveness. The clinical trial is slated to last about two years and Mass General expects to treat two to three patients a month with the new procedure.
“This clinical trial is unique in that it allows for a solid collaboration and integration of skills between experts in the Mass General Atrial Fibrillation Service and Vascular Medicine Service, both key components of the Institute for Heart, Vascular and Stroke Care,” Mansour said. “This is the most recent and most advanced treatment option to help treat our cardiac patients to improve their heart health and their overall lives.”