TY - JOUR
T1 - Renal denervation: effects on atrial electrophysiology and arrhythmias
AU - Linz, Dominik
AU - van Hunnik, Arne
AU - Ukena, Christian
AU - Ewen, Sebastian
AU - Mahfoud, Felix
AU - Schirmer, Stephan H.
AU - Lenski, Matthias
AU - Neuberger, Hans-Ruprecht
AU - Schotten, Ulrich
AU - Boehm, Michael
PY - 2014/10
Y1 - 2014/10
N2 - Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with significant morbidity and mortality. Currently, atrial endocardial catheter ablation, mainly targeting focal discharges in the pulmonary veins, is the most widely used interventional treatment of drug-refractory AF. Despite technical improvements, results are not yet optimal. There is ongoing search for alternative and/or complementary interventional targets. Conditions associated with increased sympathetic activation such as hypertension, heart failure and sleep apnea lead to structural, neural and electrophysiological changes in the atrium thereby contributing to the progression from paroxysmal to persistent AF and increasing recurrence rate of AF after PVI. Until now, interventional modulation of autonomic nervous system was limited by highly invasive techniques. Catheter-based renal denervation (RDN) was introduced as a minimally invasive approach to reduce renal and whole body sympathetic activation with accompanying blood pressure control and left-ventricular morphological and functional changes in resistant hypertension. This review focuses on the potential atrial antiarrhythmic and antiremodeling effects of RDN in AF patients with hypertension, heart failure, and sleep apnea and discusses the possible role of RDN in the treatment of AF.
AB - Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with significant morbidity and mortality. Currently, atrial endocardial catheter ablation, mainly targeting focal discharges in the pulmonary veins, is the most widely used interventional treatment of drug-refractory AF. Despite technical improvements, results are not yet optimal. There is ongoing search for alternative and/or complementary interventional targets. Conditions associated with increased sympathetic activation such as hypertension, heart failure and sleep apnea lead to structural, neural and electrophysiological changes in the atrium thereby contributing to the progression from paroxysmal to persistent AF and increasing recurrence rate of AF after PVI. Until now, interventional modulation of autonomic nervous system was limited by highly invasive techniques. Catheter-based renal denervation (RDN) was introduced as a minimally invasive approach to reduce renal and whole body sympathetic activation with accompanying blood pressure control and left-ventricular morphological and functional changes in resistant hypertension. This review focuses on the potential atrial antiarrhythmic and antiremodeling effects of RDN in AF patients with hypertension, heart failure, and sleep apnea and discusses the possible role of RDN in the treatment of AF.
KW - Atrial fibrillation
KW - Renal denervation
KW - Hypertension
KW - Heart failure
KW - Sleep apnea
U2 - 10.1007/s00392-014-0695-1
DO - 10.1007/s00392-014-0695-1
M3 - Article
C2 - 24682223
SN - 1861-0684
VL - 103
SP - 765
EP - 774
JO - Clinical research in cardiology
JF - Clinical research in cardiology
IS - 10
ER -