Purpose of Review

During the last decade, several case series and small reports have indicated that pulmonary vein isolation (PVI) in combination with renal denervation (RDN) may increase the rate of atrial fibrillation (AF) freedom in patients with hypertension. We aimed to provide a contemporary systematic overview on the techniques, and the efficacy/safety of RDN on AF recurrence, and the current landscape of ongoing investigation.

Recent Findings

The recent Evaluate Renal Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation (ERADICATE-AF) trial has demonstrated convincingly that among patients with paroxysmal AF and poorly controlled (but not “resistant”) hypertension, RDN added to catheter ablation, compared with catheter ablation alone, significantly increased the likelihood of freedom from AF at 12 months.

Summary

RDN has proven to be a unique, effective and safe interventional therapy for the management of AF. Future investigation will likely focus on confirming current findings; expanding the population of eligible patients (eg., non-hypertensives, well controlled hypertensives); determining long-term maintenance of effect and therapeutics.

中文翻译：

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房颤患者的去肾神经术

审查目的

在过去十年中，一些病例系列和小型报告表明，肺静脉隔离术 (PVI) 联合去肾神经术 (RDN) 可能会增加高血压患者的心房颤动 (AF) 消除率。我们的目的是提供关于 RDN 对 AF 复发的技术和有效性/安全性的当代系统概述，以及正在进行的调查的当前情况。

最近的发现

最近评估除导管消融以消除心房颤动的肾脏去神经支配 (ERADICATE-AF) 试验令人信服地证明，在阵发性 AF 和控制不佳（但不是“抵抗性”）高血压的患者中，与导管消融相比，RDN 添加到导管消融单独消融，显着增加了 12 个月时无房颤的可能性。

概括

RDN 已被证明是治疗 AF 的独特、有效和安全的介入疗法。未来的调查可能会侧重于确认当前的发现；扩大符合条件的患者群体（例如，非高血压患者、控制良好的高血压患者）；确定效果和治疗的长期维持。