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Drug-resistant hypertensive patients responding to multielectrode renal denervation exhibit improved heart rate dynamics and reduced arrhythmia burden

Journal of Human Hypertension volume 28, pages 587–593 (2014)Cite this article

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Abstract

Transluminal renal sympathetic denervation (RDN) reduces blood pressure (BP) in patients with drug-resistant uncontrolled hypertension. We assessed the effect of RDN on heart rate, supraventricular and ventricular ectopic activity and indexes of heart rate variability in 14 patients with drug-resistant uncontrolled hypertension who were all responders to RDN (defined as a reduction in office systolic BP ⩾10 mm Hg) at baseline and at 1 and 6 months after the procedure using the multielectrode EnligHTN ablation catheter (St Jude Medical). Office and 24-h systolic and diastolic BP were significantly reduced both at 1 and 6 months after RDN and all patients were office BP responders. There was a trend toward office heart rate reduction (by 6.9 b.p.m., P=0.064) at 1 month and a significant reduction by 10 b.p.m. (P=0.004) at 6 months. Mean 24-h Holter monitoring heart rate was reduced by 6.7 b.p.m. (P=0.022) at 1 month and by 5.3 b.p.m. (P=0.010) at 6 months after RDN. The total number of premature supraventricular and ventricular contractions was significantly decreased and time- and frequency- domain indexes were increased both at 1 and at 6 months after RDN (P<0.05 for both cases). Apart from the substantial BP lowering, RDN results in significant reduction of mean heart rate and arrhythmia burden, restoring autonomic balance in responder patients with drug-resistant uncontrolled hypertension.

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Acknowledgements

CT received Research Grant and speaker honoraria by St Jude Medical and Travel Expenses by Medtronic. This study is funded by St Jude Medical in a research grant.

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Authors and Affiliations

  1. First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece

    C Tsioufis, D Tsiachris, K Dimitriadis, A Kasiakogias, A Kordalis, V Antonakis, A Kefala, C Thomopoulos, I Kallikazaros & C Stefanadis

  2. Veterans Affairs and Georgetown University Medical Centers, Washington, DC, USA

    V Papademetriou

  3. St Jude Medical, Irvine, CA, USA

    E O-Y Lau

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  1. C Tsioufis
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Correspondence to C Tsioufis.

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Competing interests

VP is a consultant to St Jude Medical and part of the Steering Committee for EnligHTN IV. EL is an employee of St Jude Medical (SJM). SJM is the manufacturer of the device investigated in this study. She is also an employee of the advisory board members of SJM for studies related to the device investigated in this study. The remaining authors declare no conflict of interest.

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Tsioufis, C., Papademetriou, V., Tsiachris, D. et al. Drug-resistant hypertensive patients responding to multielectrode renal denervation exhibit improved heart rate dynamics and reduced arrhythmia burden. J Hum Hypertens 28, 587–593 (2014). https://doi.org/10.1038/jhh.2014.14

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  • DOI: https://doi.org/10.1038/jhh.2014.14

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