Comparison of two different radiofrequency ablation systems for renal artery denervation: Evaluation of short-term and long-term follow up.
Aged
Antihypertensive Agents
/ therapeutic use
Blood Pressure
/ drug effects
Catheter Ablation
/ adverse effects
Drug Resistance
Equipment Design
Female
Humans
Hypertension
/ diagnosis
Male
Middle Aged
Prospective Studies
Renal Artery
/ innervation
Sympathectomy
/ adverse effects
Time Factors
Treatment Outcome
catheter ablation
hypertension
renal artery intervention
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
15 02 2019
15 02 2019
Historique:
received:
29
01
2018
revised:
06
11
2018
accepted:
02
12
2018
pubmed:
15
12
2018
medline:
18
3
2020
entrez:
15
12
2018
Statut:
ppublish
Résumé
To assess the clinical efficacy of renal artery denervation (RAD) in our center and to compare the efficacy of two different radiofrequency (RF) systems. Several systems are available for RF renal denervation. Whether there is a difference in clinical efficacy among various systems remains unknown. Renal artery denervation was performed on 43 patients with resistant hypertension using either the single electrode Symplicity Flex (n = 20) or the multi-electrode EnligHTN system (n = 23). Median post-procedural follow-up was 32.93 months. The primary outcome was post-procedural change in office blood pressure (BP) within 1 year (short-term follow-up). Secondary outcomes were change in office BP between 1 and 4 years (long-term follow-up) and the difference in office BP reduction between the two systems at each follow-up period. For the total cohort, mean baseline office BP (systolic/diastolic) was 174/94 mmHg. At follow-up, mean changes in office BP from baseline were -19.70/-11.86 mmHg (P < 0.001) and -21.90/-13.94 mmHg (P < 0.001) for short-term and long-term follow-up, respectively. The differences in office BP reduction between Symplicity and EnligHTN groups were 8.96/1.23 mmHg (P = 0.42 for systolic BP, P = 0.83 for diastolic BP) and 9.56/7.68 mmHg (P = 0.14 for systolic BP, P = 0.07 for diastolic BP) for short-term and long-term follow-up, respectively. In our cohort, there was a clinically significant office BP reduction after RAD, which persisted up to 4 years. No significant difference in office BP reduction between the two systems was found.
Sections du résumé
OBJECTIVES
To assess the clinical efficacy of renal artery denervation (RAD) in our center and to compare the efficacy of two different radiofrequency (RF) systems.
BACKGROUND
Several systems are available for RF renal denervation. Whether there is a difference in clinical efficacy among various systems remains unknown.
METHODS
Renal artery denervation was performed on 43 patients with resistant hypertension using either the single electrode Symplicity Flex (n = 20) or the multi-electrode EnligHTN system (n = 23). Median post-procedural follow-up was 32.93 months. The primary outcome was post-procedural change in office blood pressure (BP) within 1 year (short-term follow-up). Secondary outcomes were change in office BP between 1 and 4 years (long-term follow-up) and the difference in office BP reduction between the two systems at each follow-up period.
RESULTS
For the total cohort, mean baseline office BP (systolic/diastolic) was 174/94 mmHg. At follow-up, mean changes in office BP from baseline were -19.70/-11.86 mmHg (P < 0.001) and -21.90/-13.94 mmHg (P < 0.001) for short-term and long-term follow-up, respectively. The differences in office BP reduction between Symplicity and EnligHTN groups were 8.96/1.23 mmHg (P = 0.42 for systolic BP, P = 0.83 for diastolic BP) and 9.56/7.68 mmHg (P = 0.14 for systolic BP, P = 0.07 for diastolic BP) for short-term and long-term follow-up, respectively.
CONCLUSIONS
In our cohort, there was a clinically significant office BP reduction after RAD, which persisted up to 4 years. No significant difference in office BP reduction between the two systems was found.
Identifiants
pubmed: 30549404
doi: 10.1002/ccd.28038
pmc: PMC6590350
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E105-E111Informations de copyright
© 2018 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc.
Références
Lancet. 2017 Nov 11;390(10108):2160-2170
pubmed: 28859944
Lancet. 2014 Feb 15;383(9917):622-9
pubmed: 24210779
Eur Heart J. 2013 Jul;34(28):2132-40
pubmed: 23782649
Eur Heart J. 2017 Jan 7;38(2):93-100
pubmed: 28158510
N Engl J Med. 2014 Apr 10;370(15):1393-401
pubmed: 24678939
Eur Heart J. 2015 Jan 21;36(4):219-27
pubmed: 25400162
J Am Soc Hypertens. 2014 Aug;8(8):593-8
pubmed: 25151320
Lancet. 2009 Apr 11;373(9671):1275-81
pubmed: 19332353
Lancet. 2010 Dec 4;376(9756):1903-9
pubmed: 21093036
Lancet. 2018 Jun 9;391(10137):2335-2345
pubmed: 29803590
J Am Heart Assoc. 2017 May 17;6(5):
pubmed: 28515119
Circulation. 2012 Dec 18;126(25):2976-82
pubmed: 23248063
EuroIntervention. 2016 Aug 05;12(5):e684-92
pubmed: 27497368
JACC Cardiovasc Interv. 2013 Jan;6(1):1-9
pubmed: 23266234
EuroIntervention. 2017 Nov 20;13(10):1242-1247
pubmed: 28741577
Lancet. 2018 Jun 9;391(10137):2346-2355
pubmed: 29803589
J Am Coll Cardiol. 2014 Aug 19;64(7):635-43
pubmed: 25125292
EuroIntervention. 2013 Oct;9(6):687-93
pubmed: 24169130
Catheter Cardiovasc Interv. 2019 Feb 15;93(3):E105-E111
pubmed: 30549404
Hypertension. 2015 Feb;65(2):393-400
pubmed: 25403610
EuroIntervention. 2014 Jun;10(2):277-84
pubmed: 24952062
Int J Cardiol. 2017 Aug 15;241:373-378
pubmed: 28465113
Hypertension. 2015 Jan;65(1):193-9
pubmed: 25331843
Int J Cardiol. 2015 Dec 15;201:345-50
pubmed: 26301677