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Renal Sympathetic Denervation

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1. Synergy of pulmonary vein isolation and catheter renal denervation in atrial fibrillation complicated with uncontrolled hypertension: Mapping the renal sympathetic nerve and pulmonary vein (the pulmonary vein isolation plus renal denervation strategy)? (PubMed)

Synergy of pulmonary vein isolation and catheter renal denervation in atrial fibrillation complicated with uncontrolled hypertension: Mapping the renal sympathetic nerve and pulmonary vein (the pulmonary vein isolation plus renal denervation strategy)? Disturbance of sympathetic and vagal nervous system participates in the pathogenesis of hypertension and atrial fibrillation (AF). Renal denervation (RDN) can modulate autonomic nervous activity and reduce blood pressure (BP) in hypertensive

2019 Journal of cardiovascular electrophysiology

2. Renal sympathetic denervation in Sweden: a report from the Swedish registry for renal denervation. (PubMed)

Renal sympathetic denervation in Sweden: a report from the Swedish registry for renal denervation. Renal denervation (RDN) is a catheter-based intervention to treat patients with resistant hypertension. The biological effects of RDN are not fully understood, and randomized controlled trials have generated conflicting evidence. This report presents data from the Swedish Registry for Renal Denervation, an investigator-driven nationwide registry.To assess the safety and efficacy of RDN on patients (...) , both P < 0.001; and 155 ± 17/89 ± 14 to 147 ± 18/82 ± 12 mmHg, both P < 0.001). Significant office and ambulatory BP reductions persisted throughout the observation period of 36 months. Major procedure-related vascular complications occurred in four patients. Renal function and number of antihypertensive drugs were unchanged during follow-up.In this complete national cohort, RDN was associated with a sustained reduction in office and ambulatory BP in patients with resistant hypertension

2018 Journal of Hypertension

3. Treatment of atrial fibrillation in patients with enhanced sympathetic tone by pulmonary vein isolation or pulmonary vein isolation and renal artery denervation: clinical background and study design : The ASAF trial: ablation of sympathetic atrial fibrill (PubMed)

Treatment of atrial fibrillation in patients with enhanced sympathetic tone by pulmonary vein isolation or pulmonary vein isolation and renal artery denervation: clinical background and study design : The ASAF trial: ablation of sympathetic atrial fibrill Hypertension is an important, modifiable risk factor for the development of atrial fibrillation (AF). Even after pulmonary vein isolation (PVI), 20-40% experience recurrent AF. Animal studies have shown that renal denervation (RDN) reduces AF (...) group, 69 patients per group are required. We plan to randomize a total of 138 hypertensive patients with AF and signs of sympathetic overdrive in a 1:1 fashion. Patients should use at least two antihypertensive drugs. Sympathetic overdrive includes obesity, exercise-induced excessive blood pressure (BP) increase, significant white coat hypertension, hospital admission or fever induced AF, tachycardia induced AF and diabetes mellitus. The interventional group will undergo PVI + RDN and the control

2018 Clinical research in cardiology : official journal of the German Cardiac Society

4. Renal sympathetic nerve activity after catheter-based renal denervation (PubMed)

Renal sympathetic nerve activity after catheter-based renal denervation Catheter-based renal sympathetic denervation (RDN) has been considered a potential treatment for therapy resistant hypertension (RHT). However, in a randomized placebo-controlled trial, RDN did not lead to a substantial blood pressure (BP) reduction. We hypothesized that variation in the reported RDN efficacy might be explained by incomplete nerve disruption as assessed by renal 123I-meta-iodobenzylguanidine (123I-mIBG (...) ). In addition, there was no significant correlation between the number of denervations and the renal 123I-mIBG parameters.No changes were observed in renal 123I-mIBG uptake or washout at 6 weeks post-RDN. These observations support incomplete renal denervation as a possible explanation for the lack of RDN efficacy.

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2018 EJNMMI research

5. Reduction of Blood Pressure Following After Renal Artery Adventitia Stripping During Total Nephroureterectomy: Potential Effect of Renal Sympathetic Denervation (PubMed)

Reduction of Blood Pressure Following After Renal Artery Adventitia Stripping During Total Nephroureterectomy: Potential Effect of Renal Sympathetic Denervation BACKGROUND Catheter-based renal sympathetic denervation has been reported to be effective for treatment resistance hypertension in Australia and Europe. However, in the blinded SYMPLICITY HTN-3 trial, renal denervation did not achieve a significant decrease in blood pressure (BP) in comparison to sham controls. There have been various (...) of catheter-based renal sympathetic denervation, although anesthesia, fluid infusion, and/or mesenteric traction may have had an influence. CONCLUSIONS A similar strategy involving thoracolumbar sympathectomy was reported about 50 years ago. The clinically significant blood pressure reduction in these patients suggests renal denervation is effective.

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2018 The American journal of case reports

6. Actualization: radiofrequency sympathetic denervation of the renal arteries for refractory arterial hypertension

Actualization: radiofrequency sympathetic denervation of the renal arteries for refractory arterial hypertension Ablación por radiofrecuencia de la inervación simpática de arterias renales para hipertensión arterial refractaria [Actualization: radiofrequency sympathetic denervation of the renal arteries for refractory arterial hypertension] Ablación por radiofrecuencia de la inervación simpática de arterias renales para hipertensión arterial refractaria [Actualization: radiofrequency (...) sympathetic denervation of the renal arteries for refractory arterial hypertension] Pichon Riviere A, Augustovski F, Garcia Marti S, Alcaraz A, Glujovsky D, Lopez A, Rey-Ares L, Bardach A, Ciapponi A, Dehese J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Pichon Riviere A, Augustovski F, Garcia Marti S, Alcaraz A, Glujovsky D, Lopez A, Rey-Ares L

2014 Health Technology Assessment (HTA) Database.

7. Renal sympathetic denervation for the treatment of resistant hypertension Renal sympathetic denervation for the treatment of resistant hypertension

Renal sympathetic denervation for the treatment of resistant hypertension Renal sympathetic denervation for the treatment of resistant hypertension Horizon Scanning Technology Prioritising Summary Renal sympathetic denervation for the treatment of resistant hypertension March 2010 © Commonwealth of Australia 2010 ISBN Publications Approval Number: This work is copyright. You may download, display, print and reproduce this material in unaltered form only (retaining this notice) for your personal (...) Assessment, Discipline of Public Health, School of Population Health and Clinical Practice, Mail Drop DX 650 545, University of Adelaide, Adelaide, SA, 5005. Renal sympathetic denervation for the treatment of resistant hypertension: March 2010 1 PRIORITISING SUMMARY REGISTER ID: 000437 NAME OF TECHNOLOGY: RENAL SYMPATHETIC DENERVATION PURPOSE AND TARGET GROUP: A MINIMALLY INVASIVE TREATMENT FOR RESISTANT HYPERTENSION STAGE OF DEVELOPMENT (IN AUSTRALIA): ? Yet to emerge ? Established ? Experimental

2010 Australia and New Zealand Horizon Scanning Network

8. Renal sympathetic denervation guided by renal nerve stimulation to treat ventricular arrhythmia in CKD patients with ICD (PubMed)

Renal sympathetic denervation guided by renal nerve stimulation to treat ventricular arrhythmia in CKD patients with ICD Chronic kidney disease (CKD) patients on stage 4 present greater risk rates for malignant ventricular arrhythmia events. This study examined patients with CKD in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, "Anti-tachycardia Therapy Pacing" (ATP) and shock (...) events during the 18 months of follow-up and compare the incidence and severity of these at different stages of CKD, mainly in patients with CKD stage 4 underwent renal sympathetic denervation (RSD) guided by renal nerve stimulation (RNS). One hundred and fifteen patients were evaluated once every three months till 18 months of follow-up. The arrhythmic events were assessed at each follow-up visit. Comparing the groups, we can see the number of ATP and shock events recorded by ICD during 18 months

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2017 Oncotarget

9. Renal sympathetic denervation increases renal blood volume per cardiac cycle: a serial magnetic resonance imaging study in resistant hypertension (PubMed)

Renal sympathetic denervation increases renal blood volume per cardiac cycle: a serial magnetic resonance imaging study in resistant hypertension Preclinical studies have demonstrated improvements in renal blood flow after renal sympathetic denervation (RSDN); however, such effects are yet to be confirmed in patients with resistant hypertension. Herein, we assessed the effects of RSDN on renal artery blood flow and diameter at multiple time points post-RSDN.Patients (n=11) with systolic blood (...) pressures ≥160 mmHg despite taking three or more antihypertensive medications at maximum tolerated dose were recruited into this single-center, prospective, non-blinded study. Magnetic resonance imaging indices included renal blood flow and renal artery diameters at baseline, 1 month and 6 months. In addition to significant decreases in blood pressures (p<0.0001), total volume of blood flow per cardiac cycle increased by 20% from 6.9±2 mL at baseline to 8.4±2 mL (p=0.003) at 1 month and to 8.0±2 mL (p

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2017 International journal of nephrology and renovascular disease

10. Pulmonary vein isolation combined with spironolactone or renal sympathetic denervation in patients with chronic kidney disease, uncontrolled hypertension, paroxysmal atrial fibrillation, and a pacemaker. (PubMed)

Pulmonary vein isolation combined with spironolactone or renal sympathetic denervation in patients with chronic kidney disease, uncontrolled hypertension, paroxysmal atrial fibrillation, and a pacemaker. Atrial fibrillation (AF) commonly occurs in chronic kidney disease (CKD), occasioning adverse outcomes. Merging pulmonary vein isolation (PVI) and renal sympathetic denervation (RSD) may decrease the recurrence of AF in subjects with CKD and uncontrolled hypertension. We considered that RSD (...) could reduce the recurrence of AF in patients with CKD by modulating sympathetic hyperactivity. We aimed to evaluate the impact of RSD or spironolactone 50 mg/day associated with PVI in reducing systolic blood pressure (BP), AF recurrence, and AF burden in patients with a history of paroxysmal AF and mild CKD.This was a single-center, prospective, longitudinal, randomized, double-blind study. The individuals were randomly divided into two groups (PVI + spironolactone, n = 36, and PVI + RSD, n = 33

2018 Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

11. Effect of renal sympathetic denervation on ventricular and neural remodeling. (PubMed)

Effect of renal sympathetic denervation on ventricular and neural remodeling. This study assessed the therapeutic effects of renal sympathetic denervation (RDN) on post-myocardial infarction (MI) ventricular remodeling and sympathetic neural remodeling in dogs. The possible mechanisms and optimal time for treatment are discussed.We randomly assigned 30 dogs to five groups: RDN 1 week before MI (RDN1w + MI; n = 6), RDN 1 week after MI (MI1w + RDN; n = 6), RDN 2 weeks after MI (MI2w + RDN; n = 6 (...) and of tyrosine hydroxylase (TH) in renal arteries was assessed by immunohistochemistry. Sympathetic innervations in the infarction border zone were investigated via Western blotting and real-time PCR.Left ventricular function in the MI group decreased significantly, while plasma BNP and ET-1 levels as well as MMP-2 and MMP-9 expression increased. Compared with the MI group, the RD groups showed significantly reduced MMP‑2, MMP‑9, TH, and growth-associated protein (GAP) 43 expression in the RDN1w + MI, MI1w 

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2018 Herz

12. Predictors for profound blood pressure response in patients undergoing renal sympathetic denervation. (PubMed)

Predictors for profound blood pressure response in patients undergoing renal sympathetic denervation. Renal sympathetic denervation (RDN) as treatment for hypertension shows highly variable results. Although some patients do not show any blood pressure (BP) change and in most patients a BP reduction of at least 5 mmHg can be found, some show a reduction at least 20 mmHg. We sought to identify predictors for such a profound BP response.Profound BP response was defined as drop of at least 20 mmHg (...) in daytime systolic ambulatory BP measurement (ABPM) 3 months after catheter-based RDN. Three different denervation devices were used for RDN, and pulse wave velocity was determined invasively in a subgroup of patients.One hundred and ninety consecutive patients were included in this analysis. Profound BP response was found in 33 patients. Patients with profound BP response were younger (P = 0.04), presented with higher baseline ABPM values (P < 0.001), were treated with ultrasound-based RDN and received

2018 Journal of Hypertension

13. Effects of renal sympathetic denervation on myocardial structure, function and perfusion: A serial CMR study. (PubMed)

Effects of renal sympathetic denervation on myocardial structure, function and perfusion: A serial CMR study. Echocardiographic studies have shown improvements in cardiac indices associated with renal sympathetic denervation (RDN), however, the benefits on myocardial perfusion have never been assessed. This trial was designed to study the effects of RDN on myocardial perfusion using cardiac magnetic resonance (CMR) imaging.A total of 14 patients with resistant hypertension were recruited (...) 46 ± 4% at baseline to 41 ± 8% at 6 months (p = 0.002).This study demonstrates that renal sympathetic denervation increased myocardial perfusion by 32% as assessed by CMR, and, this was associated with improvements in cardiac volumes and function. Larger well controlled and randomized studies are required to assess the clinical significance of these findings.Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

2018 Atherosclerosis

14. Renal Sympathetic Denervation From the Adventitia on Resistant Hypertension(RSDARH)

Renal Sympathetic Denervation From the Adventitia on Resistant Hypertension(RSDARH) Renal Sympathetic Denervation From the Adventitia on Resistant Hypertension(RSDARH) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Renal Sympathetic Denervation From the Adventitia on Resistant Hypertension(RSDARH) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03758196 Recruitment Status : Recruiting First Posted : November 29, 2018

2018 Clinical Trials

15. Prevalence and consequences of noncardiac incidental findings on preprocedural imaging in the workup for transcatheter aortic valve implantation, renal sympathetic denervation, or MitraClip implantation. (PubMed)

Prevalence and consequences of noncardiac incidental findings on preprocedural imaging in the workup for transcatheter aortic valve implantation, renal sympathetic denervation, or MitraClip implantation. Dedicated data on the prevalence of incidental findings (IF) stratified according to overall clinical relevance and their subsequent correlation to outcome are lacking. The aim of the present study was to describe the prevalence and consequences of noncardiac IF on computed tomography (...) or magnetic resonance imaging in the workup for interventional cardiovascular procedures.A total of 916 patients underwent preprocedural computed tomography or magnetic resonance imaging in the workup for transcatheter aortic valve implantation (TAVI), renal sympathetic denervation (RDN), or MitraClip implantation.IF were found in 395 of 916 patients (43.1%), with an average of 1.8 IF per patient. Classifying the IF resulted in 155 patients with minor, 171 patients with moderate, and 69 patients

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2018 American Heart Journal

16. Accurate Depth of Radiofrequency-Induced Lesions in Renal Sympathetic Denervation Based on a Fine Histological Sectioning Approach in a Porcine Model (PubMed)

Accurate Depth of Radiofrequency-Induced Lesions in Renal Sympathetic Denervation Based on a Fine Histological Sectioning Approach in a Porcine Model Ablation lesion depth caused by radiofrequency-based renal denervation (RDN) was limited to <4 mm in previous animal studies, suggesting that radiofrequency-RDN cannot ablate a substantial percentage of renal sympathetic nerves. We aimed to define the true lesion depth achieved with radiofrequency-RDN using a fine sectioning method (...) and to investigate biophysical parameters that could predict lesion depth.Radiofrequency was delivered to 87 sites in 14 renal arteries from 9 farm pigs at various ablation settings: 2, 4, 6, and 9 W for 60 seconds and 6 W for 120 seconds. Electric impedance and electrode temperature were recorded during ablation. At 7 days, 2470 histological sections were obtained from the treated arteries. Maximum lesion depth increased at 2 to 6 W, peaking at 6.53 (95% confidence interval, 4.27-8.78) mm under the 6 W/60 s

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2018 Circulation. Cardiovascular interventions

17. Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial (PubMed)

Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness and can reliably be obtained by CMR. This analysis sought

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2018 Clinical Research in Cardiology

18. Renal denervation for resistant hypertension. (PubMed)

Renal denervation for resistant hypertension. Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal (...) sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition.We sought to evaluate the short- and long-term effects of renal denervation in individuals with resistant hypertension on clinical end points, including fatal and non-fatal cardiovascular events, all-cause mortality, hospital admissions, quality of life, blood pressure control, left ventricular hypertrophy, cardiovascular and metabolic profile, and kidney function, as well

2017 Cochrane

19. [Renal sympathetic denervation as treatment of resistant hypertension]

[Renal sympathetic denervation as treatment of resistant hypertension] Denervación simpática renal mediante ablación endovascular por radiofrecuencia en el tratamiento de la hipertensión arterial resistente [Renal sympathetic denervation as treatment of resistant hypertension] Denervación simpática renal mediante ablación endovascular por radiofrecuencia en el tratamiento de la hipertensión arterial resistente [Renal sympathetic denervation as treatment of resistant hypertension] Atienza Merino (...) G, Maceira Rozas MC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Atienza Merino G, Maceira Rozas MC. Denervación simpática renal mediante ablación endovascular por radiofrecuencia en el tratamiento de la hipertensión arterial resistente. [Renal sympathetic denervation as treatment of resistant hypertension] Santiago de Compostela

2013 Health Technology Assessment (HTA) Database.

20. Renal sympathetic denervation in patients with therapy resistant hypertension

Renal sympathetic denervation in patients with therapy resistant hypertension Renal sympathetic denervation in patients with therapy resistant hypertension Renal sympathetic denervation in patients with therapy resistant hypertension Andersson B, Herlitz H, Manhem K, Zachrisson K, Völz S, Daxberg EL, Holmberg Y, Samuelsson O Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database (...) . Citation Andersson B, Herlitz H, Manhem K, Zachrisson K, Völz S, Daxberg EL, Holmberg Y, Samuelsson O. Renal sympathetic denervation in patients with therapy resistant hypertension. Gothenburg: The Regional Health Technology Assessment Centre (HTA-centrum). HTA-rapport 2013:56. 2013 Authors' objectives Is RDN an effective and safe technique to lower the blood pressure in patients with treatment resistant hypertension, and does it result in reduced mortality and less target organ damage? Authors

2013 Health Technology Assessment (HTA) Database.

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