The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients
Background Atrial fibrillation (AF) frequently complicates chronic kidney disease (CKD). AF treatment is challenging and requires complete pulmonary vein isolation (PVI). Recently, renal sympathetic denervation (RSD) has been reported to reduce AF recurrence when performed alongside PVI. Methods A p...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2017-03, Vol.48 (2), p.215-222 |
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| creator | Kiuchi, Márcio Galindo Chen, Shaojie e Silva, Gustavo Ramalho Rodrigues Paz, Luis Marcelo Kiuchi, Tetsuaki de Paula Filho, Ary Getulio Lima Souto, Gladyston Luiz |
| description | Background
Atrial fibrillation (AF) frequently complicates chronic kidney disease (CKD). AF treatment is challenging and requires complete pulmonary vein isolation (PVI). Recently, renal sympathetic denervation (RSD) has been reported to reduce AF recurrence when performed alongside PVI.
Methods
A prospective therapeutic study of patients with controlled hypertension and paroxysmal AF was undertaken. Renal function was evaluated using estimated glomerular filtration rate. Outcomes for patients with normal renal function who underwent PVI (
n
= 101) were compared with those for CKD patients who underwent either PVI alone (
n
= 96) or PVI + RSD (
n
= 39). The primary endpoint was recurrence of AF recorded by 24-h Holter monitoring.
Results
During the 22.4 ± 12.1 months following intervention, the incidence of AF recurrence was higher in CKD patients treated with PVI alone (61.5 %) than in CKD patients treated with PVI + RSD (38.5 %; HR 1.86, 95 % CI 1.14–3.03,
P
= 0.0251) or patients without CKD subjected to PVI (35.6 %; hazard ratio (HR) 2.27, 95 % confidence interval (CI) 1.51–3.42,
P
|
| doi_str_mv | 10.1007/s10840-016-0186-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1877848249</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4317053921</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-c07f589c0a17b07f58c8693b810a19ea7a42c76deb122f0ed94f36008e13ad9a3</originalsourceid><addsrcrecordid>eNqNkc9qFTEUxoMotrY-gBsJuHEzNpnM5M9SirZCwU2F7kImOeNNnUnGZKZ4H8c3NXPnKiIIXYQTcr7vd8L5EHpFyTtKiLjIlMiGVITyciSv-BN0SltRV7JV7dNyZ5JVUrR3J-hFzveEEEVq_hyd1EKQhlFxin7e7gAb5_zsY8CxxwmCGXDej5OZdzB7ix0ESA_mIJgjnpZhjMGkPX4AH7DPcdh6CdxiIZdql1QwFlbeZFL8sc9jgZo5-VJ63yU_HE2FYHcphjLnm3cB9tj5DCZDMc4ewpzP0bPeDBleHusZ-vLxw-3ldXXz-erT5fubyjaknStLRN9KZYmhojvcreSKdZKWFwVGmKa2gjvoaF33BJxqesYJkUCZccqwM_R2404pfl8gz3r02UL5aIC4ZE2lELKRdaMeIWVtYSu5St_8I72PSyorPgCp4IyqVUU3lU0x5wS9npIfy441JXqNWm9R6xK1XqPWvHheH8lLN4L74_idbRHUmyCXVvgK6a_R_6X-AvjSt5Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1871763199</pqid></control><display><type>article</type><title>The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Kiuchi, Márcio Galindo ; Chen, Shaojie ; e Silva, Gustavo Ramalho ; Rodrigues Paz, Luis Marcelo ; Kiuchi, Tetsuaki ; de Paula Filho, Ary Getulio ; Lima Souto, Gladyston Luiz</creator><creatorcontrib>Kiuchi, Márcio Galindo ; Chen, Shaojie ; e Silva, Gustavo Ramalho ; Rodrigues Paz, Luis Marcelo ; Kiuchi, Tetsuaki ; de Paula Filho, Ary Getulio ; Lima Souto, Gladyston Luiz</creatorcontrib><description>Background
Atrial fibrillation (AF) frequently complicates chronic kidney disease (CKD). AF treatment is challenging and requires complete pulmonary vein isolation (PVI). Recently, renal sympathetic denervation (RSD) has been reported to reduce AF recurrence when performed alongside PVI.
Methods
A prospective therapeutic study of patients with controlled hypertension and paroxysmal AF was undertaken. Renal function was evaluated using estimated glomerular filtration rate. Outcomes for patients with normal renal function who underwent PVI (
n
= 101) were compared with those for CKD patients who underwent either PVI alone (
n
= 96) or PVI + RSD (
n
= 39). The primary endpoint was recurrence of AF recorded by 24-h Holter monitoring.
Results
During the 22.4 ± 12.1 months following intervention, the incidence of AF recurrence was higher in CKD patients treated with PVI alone (61.5 %) than in CKD patients treated with PVI + RSD (38.5 %; HR 1.86, 95 % CI 1.14–3.03,
P
= 0.0251) or patients without CKD subjected to PVI (35.6 %; hazard ratio (HR) 2.27, 95 % confidence interval (CI) 1.51–3.42,
P
< 0.0001). In particular, the addition of RSD to PVI significantly reduced AF recurrence in CKD stage 4, but not stage 2 or 3, patients. Ambulatory blood pressure and mean heart rate were not different between groups or time points. No complications of either procedure were observed.
Conclusions
PVI + RSD is a safe treatment that is superior to PVI alone for treatment of paroxysmal AF in CKD patients.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-016-0186-6</identifier><identifier>PMID: 27704317</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Atrial Fibrillation - epidemiology ; Atrial Fibrillation - surgery ; Brazil - epidemiology ; Cardiology ; Catheter Ablation - utilization ; Combined Modality Therapy - statistics & numerical data ; Comorbidity ; Female ; Humans ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Pulmonary Veins - surgery ; Recurrence ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - surgery ; Risk Assessment ; Secondary Prevention - statistics & numerical data ; Sympathectomy, Chemical - utilization ; Treatment Outcome</subject><ispartof>Journal of interventional cardiac electrophysiology, 2017-03, Vol.48 (2), p.215-222</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>Journal of Interventional Cardiac Electrophysiology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-c07f589c0a17b07f58c8693b810a19ea7a42c76deb122f0ed94f36008e13ad9a3</citedby><cites>FETCH-LOGICAL-c405t-c07f589c0a17b07f58c8693b810a19ea7a42c76deb122f0ed94f36008e13ad9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-016-0186-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-016-0186-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27704317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiuchi, Márcio Galindo</creatorcontrib><creatorcontrib>Chen, Shaojie</creatorcontrib><creatorcontrib>e Silva, Gustavo Ramalho</creatorcontrib><creatorcontrib>Rodrigues Paz, Luis Marcelo</creatorcontrib><creatorcontrib>Kiuchi, Tetsuaki</creatorcontrib><creatorcontrib>de Paula Filho, Ary Getulio</creatorcontrib><creatorcontrib>Lima Souto, Gladyston Luiz</creatorcontrib><title>The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Background
Atrial fibrillation (AF) frequently complicates chronic kidney disease (CKD). AF treatment is challenging and requires complete pulmonary vein isolation (PVI). Recently, renal sympathetic denervation (RSD) has been reported to reduce AF recurrence when performed alongside PVI.
Methods
A prospective therapeutic study of patients with controlled hypertension and paroxysmal AF was undertaken. Renal function was evaluated using estimated glomerular filtration rate. Outcomes for patients with normal renal function who underwent PVI (
n
= 101) were compared with those for CKD patients who underwent either PVI alone (
n
= 96) or PVI + RSD (
n
= 39). The primary endpoint was recurrence of AF recorded by 24-h Holter monitoring.
Results
During the 22.4 ± 12.1 months following intervention, the incidence of AF recurrence was higher in CKD patients treated with PVI alone (61.5 %) than in CKD patients treated with PVI + RSD (38.5 %; HR 1.86, 95 % CI 1.14–3.03,
P
= 0.0251) or patients without CKD subjected to PVI (35.6 %; hazard ratio (HR) 2.27, 95 % confidence interval (CI) 1.51–3.42,
P
< 0.0001). In particular, the addition of RSD to PVI significantly reduced AF recurrence in CKD stage 4, but not stage 2 or 3, patients. Ambulatory blood pressure and mean heart rate were not different between groups or time points. No complications of either procedure were observed.
Conclusions
PVI + RSD is a safe treatment that is superior to PVI alone for treatment of paroxysmal AF in CKD patients.</description><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Brazil - epidemiology</subject><subject>Cardiology</subject><subject>Catheter Ablation - utilization</subject><subject>Combined Modality Therapy - statistics & numerical data</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Pulmonary Veins - surgery</subject><subject>Recurrence</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - surgery</subject><subject>Risk Assessment</subject><subject>Secondary Prevention - statistics & numerical data</subject><subject>Sympathectomy, Chemical - utilization</subject><subject>Treatment Outcome</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkc9qFTEUxoMotrY-gBsJuHEzNpnM5M9SirZCwU2F7kImOeNNnUnGZKZ4H8c3NXPnKiIIXYQTcr7vd8L5EHpFyTtKiLjIlMiGVITyciSv-BN0SltRV7JV7dNyZ5JVUrR3J-hFzveEEEVq_hyd1EKQhlFxin7e7gAb5_zsY8CxxwmCGXDej5OZdzB7ix0ESA_mIJgjnpZhjMGkPX4AH7DPcdh6CdxiIZdql1QwFlbeZFL8sc9jgZo5-VJ63yU_HE2FYHcphjLnm3cB9tj5DCZDMc4ewpzP0bPeDBleHusZ-vLxw-3ldXXz-erT5fubyjaknStLRN9KZYmhojvcreSKdZKWFwVGmKa2gjvoaF33BJxqesYJkUCZccqwM_R2404pfl8gz3r02UL5aIC4ZE2lELKRdaMeIWVtYSu5St_8I72PSyorPgCp4IyqVUU3lU0x5wS9npIfy441JXqNWm9R6xK1XqPWvHheH8lLN4L74_idbRHUmyCXVvgK6a_R_6X-AvjSt5Q</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Kiuchi, Márcio Galindo</creator><creator>Chen, Shaojie</creator><creator>e Silva, Gustavo Ramalho</creator><creator>Rodrigues Paz, Luis Marcelo</creator><creator>Kiuchi, Tetsuaki</creator><creator>de Paula Filho, Ary Getulio</creator><creator>Lima Souto, Gladyston Luiz</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients</title><author>Kiuchi, Márcio Galindo ; Chen, Shaojie ; e Silva, Gustavo Ramalho ; Rodrigues Paz, Luis Marcelo ; Kiuchi, Tetsuaki ; de Paula Filho, Ary Getulio ; Lima Souto, Gladyston Luiz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-c07f589c0a17b07f58c8693b810a19ea7a42c76deb122f0ed94f36008e13ad9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Brazil - epidemiology</topic><topic>Cardiology</topic><topic>Catheter Ablation - utilization</topic><topic>Combined Modality Therapy - statistics & numerical data</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Pulmonary Veins - surgery</topic><topic>Recurrence</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - surgery</topic><topic>Risk Assessment</topic><topic>Secondary Prevention - statistics & numerical data</topic><topic>Sympathectomy, Chemical - utilization</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiuchi, Márcio Galindo</creatorcontrib><creatorcontrib>Chen, Shaojie</creatorcontrib><creatorcontrib>e Silva, Gustavo Ramalho</creatorcontrib><creatorcontrib>Rodrigues Paz, Luis Marcelo</creatorcontrib><creatorcontrib>Kiuchi, Tetsuaki</creatorcontrib><creatorcontrib>de Paula Filho, Ary Getulio</creatorcontrib><creatorcontrib>Lima Souto, Gladyston Luiz</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiuchi, Márcio Galindo</au><au>Chen, Shaojie</au><au>e Silva, Gustavo Ramalho</au><au>Rodrigues Paz, Luis Marcelo</au><au>Kiuchi, Tetsuaki</au><au>de Paula Filho, Ary Getulio</au><au>Lima Souto, Gladyston Luiz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>48</volume><issue>2</issue><spage>215</spage><epage>222</epage><pages>215-222</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Background
Atrial fibrillation (AF) frequently complicates chronic kidney disease (CKD). AF treatment is challenging and requires complete pulmonary vein isolation (PVI). Recently, renal sympathetic denervation (RSD) has been reported to reduce AF recurrence when performed alongside PVI.
Methods
A prospective therapeutic study of patients with controlled hypertension and paroxysmal AF was undertaken. Renal function was evaluated using estimated glomerular filtration rate. Outcomes for patients with normal renal function who underwent PVI (
n
= 101) were compared with those for CKD patients who underwent either PVI alone (
n
= 96) or PVI + RSD (
n
= 39). The primary endpoint was recurrence of AF recorded by 24-h Holter monitoring.
Results
During the 22.4 ± 12.1 months following intervention, the incidence of AF recurrence was higher in CKD patients treated with PVI alone (61.5 %) than in CKD patients treated with PVI + RSD (38.5 %; HR 1.86, 95 % CI 1.14–3.03,
P
= 0.0251) or patients without CKD subjected to PVI (35.6 %; hazard ratio (HR) 2.27, 95 % confidence interval (CI) 1.51–3.42,
P
< 0.0001). In particular, the addition of RSD to PVI significantly reduced AF recurrence in CKD stage 4, but not stage 2 or 3, patients. Ambulatory blood pressure and mean heart rate were not different between groups or time points. No complications of either procedure were observed.
Conclusions
PVI + RSD is a safe treatment that is superior to PVI alone for treatment of paroxysmal AF in CKD patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27704317</pmid><doi>10.1007/s10840-016-0186-6</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 1383-875X |
| ispartof | Journal of interventional cardiac electrophysiology, 2017-03, Vol.48 (2), p.215-222 |
| issn | 1383-875X 1572-8595 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Atrial Fibrillation - epidemiology Atrial Fibrillation - surgery Brazil - epidemiology Cardiology Catheter Ablation - utilization Combined Modality Therapy - statistics & numerical data Comorbidity Female Humans Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Pulmonary Veins - surgery Recurrence Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - surgery Risk Assessment Secondary Prevention - statistics & numerical data Sympathectomy, Chemical - utilization Treatment Outcome |
| title | The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients |
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