Sachin Yalagudri1, Narayana Raju2, Bharati Das3, Ashwin Daware4, Shreesha Maiya5, Kannan Jothiraj6, A G Ravikishore7. 1. Fellow in Cardiac Electrophysiology, Narayana Hrudayalaya, Bangalore, India. Electronic address: pedssachin@gmail.com. 2. Senior Resident, Dept of Cardiology, Narayana Hrudayalaya, Bangalore, India. 3. Fellow in Cardiac Electrophysiology, Narayana Hrudayalaya, Bangalore, India. 4. Consultant Cardiologist, Narayana Hrudayalaya, Bangalore, India. 5. Consultant Paediatric Cardiologist and Electrophysiologist, Narayana Hrudayalaya, Bangalore, India. 6. Senior Consultant Cardiologist and Electrophysiologist, Narayana Hrudayalaya, Bangalore, India. 7. Head of Electrophysiology and Arrhythmia Services, Narayana Hrudayalaya, Bangalore, India.
Abstract
OBJECTIVES: This study was conducted to assess the acute safety and short term efficacy of renal sympathetic denervation (RSDN) using solid tip radiofrequency ablation (RFA) catheter and saline irrigation through the renal guiding catheter to achieve effective denervation. BACKGROUND: RSDN using a specialized solid-tip RFA catheter has recently been demonstrated to safely reduce systemic blood pressure in patients with refractory hypertension, the limitation being inadequate power delivery in renal arteries. So, we used solid-tip RFA catheter along with saline irrigation for RSDN. METHODS: Nine patients with resistant hypertension underwent CT and conventional renal angiography, followed by bilateral or unilateral RSDN using 5F RFA catheter with saline irrigation through renal guiding catheter. Repeat renal angiography was performed at the end of the procedure. In all patients, pre- and post-procedure serum creatinine was measured. RESULTS: Over 1-month period: 1) the systolic/diastolic blood pressure decreased by -57 ± 20/-25 ± 7.5 mm Hg; 2) all patients experienced a decrease in systolic blood pressure of at least -36 mm Hg (range 36-98 mm Hg); 3) there was no evidence of renal artery injury immediate post-procedure. There was no significant change in serum creatinine level. CONCLUSIONS: This data shows the acute procedural safety and short term efficacy of RSDN using modified externally irrigated solid tip RFA catheter.
OBJECTIVES: This study was conducted to assess the acute safety and short term efficacy of renal sympathetic denervation (RSDN) using solid tip radiofrequency ablation (RFA) catheter and saline irrigation through the renal guiding catheter to achieve effective denervation. BACKGROUND: RSDN using a specialized solid-tip RFA catheter has recently been demonstrated to safely reduce systemic blood pressure in patients with refractory hypertension, the limitation being inadequate power delivery in renal arteries. So, we used solid-tip RFA catheter along with saline irrigation for RSDN. METHODS: Nine patients with resistant hypertension underwent CT and conventional renal angiography, followed by bilateral or unilateral RSDN using 5F RFA catheter with saline irrigation through renal guiding catheter. Repeat renal angiography was performed at the end of the procedure. In all patients, pre- and post-procedure serum creatinine was measured. RESULTS: Over 1-month period: 1) the systolic/diastolic blood pressure decreased by -57 ± 20/-25 ± 7.5 mm Hg; 2) all patients experienced a decrease in systolic blood pressure of at least -36 mm Hg (range 36-98 mm Hg); 3) there was no evidence of renal artery injury immediate post-procedure. There was no significant change in serum creatinine level. CONCLUSIONS: This data shows the acute procedural safety and short term efficacy of RSDN using modified externally irrigated solid tip RFA catheter.
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