期刊
CLINICAL RESEARCH IN CARDIOLOGY
卷 105, 期 10, 页码 873-879出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s00392-016-1012-y
关键词
Heart failure; Ventricular fibrillation; Electrical storm; Renal denervation
资金
- Ministry of Science and Economy of the Saarland
- Deutsche Hochdruckliga
- Deutsche Forschungsgemeinschaft [KFO 196]
- Deutsche Gesellschaft fur Kardiologie
- DZHK (Deutsches Zentrum fur Herz-Kreislauf-Forschung-German Center for Cardiovascular Research)
- BMBF (German Ministry of Education and Research)
- Medtronic
- Biosense Webster
Ventricular arrhythmias (VAs) in patients with chronic heart failure (CHF) are sometimes refractory to antiarrhythmic drugs and cardiac ablation. This study aimed to investigate catheter-based renal sympathetic denervation (RDN) as antiarrhythmic strategy in refractory VA. These are the first data from a pooled analysis of 13 cases from five large international centers (age 59.2 +/- 14.4 years, all male) with CHF (ejection fraction 25.8 +/- 10.1 %, NYHA class 2.6 +/- 1) presented with refractory VA who underwent RDN. Ventricular arrhythmias, ICD therapies, clinical status, and blood pressure (BP) were evaluated before and 1-12 months after RDN. Within 4 weeks prior RDN, a median of 21 (interquartile range 10-30) ventricular tachycardia (VT) or fibrillation (VF) episodes occurred despite antiarrhythmic drugs and prior cardiac ablation. RDN was performed bilaterally with a total number of 12.5 +/- 3.5 ablations and without peri-procedural complications. One and 3 months after RDN, VT/VF episodes were reduced to 2 (0-7) (p = 0.004) and 0 (p = 0.006), respectively. Four (31 %) and 11 (85 %) patients of these 13 patients were free from VA at 1 and 3 months. Although BP was low at baseline (116 +/- 18/73 +/- 13 mmHg), no significant changes of BP or NYHA class were observed after RDN. During follow-up, three patients died from non-rhythm-related causes. In patients with CHF and refractory VA, RDN appears to be safe concerning peri-procedural complications and blood pressure changes, and is associated with a reduced arrhythmic burden.
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