Influence of renal denervation on atrial tachyarrhythmia recurrence in patients with resistant hypertension and atrial fibrillation

Objective. The aim of this prospective randomized study was to assess the impact of renal artery denervation on patients with refractory AF and drug resistant hypertension, for whom pulmonary vein isolation (PVI) was recommended. Methods. Patients with symptomatic paroxysmal or persistent AF refractory to ≥2 antiarrhythmic drugs and drug-resistant hypertension (systolic blood pressure >160 mm Hg despite triple drug therapy) were eligible for enrolment. 50 consenting patients were randomized to PVI only (n = 25) or PVI with renal artery denervation (n = 25). All patients were followed during 18 months to assess sinus rhythm stability and to monitor blood pressure changes. Results. Out of 25, 16 (64%) patients treated with PVI and renal denervation versus 6 (24%) of the 25 patients in the PVI-only group (p=0.004, log-rank test) were AF-free at 18-month post ablation follow-up. At the end of follow-up, significant reductions in systolic (–27±4 mm Hg) and diastolic blood pressure (–11±2 mm Hg) were observed in patients treated with PVI with renal denervation, with no significant changes in the PVI only group. Conclusion. Renal artery denervation combined with PVI reduces AF recurrence and systolic/diastolic blood pressure, as compared with conventional AF ablation, in patients with drug-resistant hypertension and AF.