Novel Use of NavX Three-Dimensional Mapping to Guide Renal Artery Denervation

Objectives To assess the clinical efficacy of renal artery denervation (RAD) in our center and to compare the efficacy of two different radiofrequency (RF) systems. Background Several systems are available for RF renal denervation. Whether there is a difference in clinical efficacy among various systems remains unknown. Methods Renal artery denervation was performed on 43 patients with resistant hypertension using either the single electrode Symplicity Flex (n = 20) or the multi‐electrode EnligHTN system (n = 23). Median post‐procedural follow‐up was 32.93 months. The primary outcome was post‐procedural change in office blood pressure (BP) within 1 year (short‐term follow‐up). Secondary outcomes were change in office BP between 1 and 4 years (long‐term follow‐up) and the difference in office BP reduction between the two systems at each follow‐up period. Results For the total cohort, mean baseline office BP (systolic/diastolic) was 174/94 mmHg. At follow‐up, mean changes in office BP from baseline were −19.70/−11.86 mmHg ( P < 0.001) and −21.90/−13.94 mmHg ( P < 0.001) for short‐term and long‐term follow‐up, respectively. The differences in office BP reduction between Symplicity and EnligHTN groups were 8.96/1.23 mmHg ( P = 0.42 for systolic BP, P = 0.83 for diastolic BP) and 9.56/7.68 mmHg ( P = 0.14 for systolic BP, P = 0.07 for diastolic BP) for short‐term and long‐term follow‐up, respectively. Conclusions In our cohort, there was a clinically significant office BP reduction after RAD, which persisted up to 4 years. No significant difference in office BP reduction between the two systems was found.

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“…Renal artery tortuosity index was calculated for each patient using the arc: chord ratio method, as described previously. 13…”

Section: Study Populationmentioning

confidence: 99%

Comparison of two different radiofrequency ablation systems for renal artery denervation: Evaluation of short‐term and long‐term follow up

Raisi

Pouliopoulos

Qian

et al. 2018

Cathet Cardio Intervent

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“…Even more recently, 3D electrical current mapping technology, commonly applied in cardiac electrophysiology (EP) procedures, has been used to further reduce both contrast load and radiation exposure. 33 Further iterations of RF RSD devices include integrated cooling mechanisms to prevent local tissue heating to excessive levels (see Table 1). First-generation systems have utilised concurrent renal artery blood flow to aid cooling of the endothelium to prevent thermal damage.…”

Section: Radio-frequency Neural Ablationmentioning

confidence: 99%

Renal Sympathetic Denervation – A Review of Applications in Current Practice

Kapil

Jain

Lobo

2011

Interventional Cardiology Review

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Resistant hypertension is associated with high morbidity and mortality despite numerous pharmacological strategies. A wealth of preclinical and clinical data have demonstrated that resistant hypertension is associated with elevated renal and central sympathetic tone. The development of interventional therapies to modulate the sympathetic nervous system potentially represents a paradigm shift in the strategy for blood pressure control in this subset of patients. Initial first-in-man and pivotal, randomised controlled trials of endovascular, radio-frequency renal sympathetic denervation have spawned numerous iterations of similar technology, as well as many novel concepts for achieving effective renal sympatholysis. This review details the current knowledge of these devices and the evidence base behind each technology.

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Novel Use of NavX Three-Dimensional Mapping to Guide Renal Artery Denervation

Cited by 2 publications

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Comparison of two different radiofrequency ablation systems for renal artery denervation: Evaluation of short‐term and long‐term follow up

Comparison of two different radiofrequency ablation systems for renal artery denervation: Evaluation of short‐term and long‐term follow up

Renal Sympathetic Denervation – A Review of Applications in Current Practice

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