Ventricular arrhythmia episodes may decrease after renal denervation in resistant hypertensive patients


A small study presented at ACC 2013 has shown that renal denervation, besides reducing resistant hypertension, produces a favourable effect on atrial and ventricular arrhythmias.

Konstantinos Tsioufis, First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece, and colleagues set out to assess the effect of renal denervation on heart rate and cardiac arrhythmias in resistant hypertension patients.

In the study, the researchers treated 14 patients with resistant hypertension who underwent ambulatory blood pressure measurements and Holter monitoring at baseline and one month after renal denervation.

For the procedure, the investigators used the EnligHTN ablation catheter (St Jude Medical). Patients with grade II and above of the Lown-Wolf classification were considered to have complex ventricular arrhythmias while the presence of ≥3 consecutive premature supraventricular contractions was defined as paroxysmal atrial fibrillation.

The authors found that after one month, office and 24-hour blood pressure was significantly reduced by 38/14.1mmHg, p<0.001/0.003 and 18/9.5mmHg, p<0.001/0.001, respectively. Office heart rate was reduced by 7bpm, (p=0.046), ambulatory heart rate by 5.5bpm, and average 24-hour heart rate by 6.7 bpm (p=0.022).

The researchers also found that complex ventricular arrhythmias were present in five out of the 14 patients (one with non sustained ventricular tachycardia and four with ventricular couplets) at baseline but persisted only in two of them one month after renal denervation (two patients with ventricular couplets). The number of premature ventricular contractions was significantly decreased after renal denervation (from 2.23/hour to 0.39/hour, p=0.019). Episodes of paroxysmal atrial fibrillation were detected in five of 14 subjects at baseline and in two of those patients one month after renal denervation. The total number of premature supraventricular contractions was also significantly decreased after renal denervation from 1.62/hour to 0.72/hour (p=0.039), the authors found.

There was no relationship between the observed difference in premature supraventricular and ventricular contractions after renal denervation and the drop in office and 24hour blood pressure.

To conclude, Tsioufis told Cardiac Rhythm News: “Based on the existing data in a small number of patients renal sympathetic denervation, by the delivery of radiofrequency energy though the multi-electrode EnligHTN system, is a safe and effective method for reducing the high blood pressure in patients suffering from resistant hypertension with additional promising favourable ‘pleotropic’ effects on the arrythmias’ profile of these patients.”