Arwa Younis1, Jonathan S Steinberg2. 1. Clinical Cardiovascular Research Center, University of Rochester School of Medicine and Dentistry, 85 Woodland Road, Short Hills, NJ, 07078, USA. 2. Clinical Cardiovascular Research Center, University of Rochester School of Medicine and Dentistry, 85 Woodland Road, Short Hills, NJ, 07078, USA. jsteinberg@smgnj.com.
Abstract
PURPOSE OF REVIEW: During the last decade, several case series and small reports have indicated that pulmonary vein isolation (PVI) in combination with renal denervation (RDN) may increase the rate of atrial fibrillation (AF) freedom in patients with hypertension. We aimed to provide a contemporary systematic overview on the techniques, and the efficacy/safety of RDN on AF recurrence, and the current landscape of ongoing investigation. RECENT FINDINGS: The recent Evaluate Renal Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation (ERADICATE-AF) trial has demonstrated convincingly that among patients with paroxysmal AF and poorly controlled (but not "resistant") hypertension, RDN added to catheter ablation, compared with catheter ablation alone, significantly increased the likelihood of freedom from AF at 12 months. RDN has proven to be a unique, effective and safe interventional therapy for the management of AF. Future investigation will likely focus on confirming current findings; expanding the population of eligible patients (eg., non-hypertensives, well controlled hypertensives); determining long-term maintenance of effect and therapeutics.
PURPOSE OF REVIEW: During the last decade, several case series and small reports have indicated that pulmonary vein isolation (PVI) in combination with renal denervation (RDN) may increase the rate of atrial fibrillation (AF) freedom in patients with hypertension. We aimed to provide a contemporary systematic overview on the techniques, and the efficacy/safety of RDN on AF recurrence, and the current landscape of ongoing investigation. RECENT FINDINGS: The recent Evaluate Renal Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation (ERADICATE-AF) trial has demonstrated convincingly that among patients with paroxysmal AF and poorly controlled (but not "resistant") hypertension, RDN added to catheter ablation, compared with catheter ablation alone, significantly increased the likelihood of freedom from AF at 12 months. RDN has proven to be a unique, effective and safe interventional therapy for the management of AF. Future investigation will likely focus on confirming current findings; expanding the population of eligible patients (eg., non-hypertensives, well controlled hypertensives); determining long-term maintenance of effect and therapeutics.