Comparison of two different radiofrequency ablation systems for renal artery denervation: Evaluation of short-term and long-term follow up

Catheter Cardiovasc Interv. 2019 Feb 15;93(3):E105-E111. doi: 10.1002/ccd.28038. Epub 2018 Dec 14.

Abstract

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.

Keywords: catheter ablation; hypertension; renal artery intervention.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure* / drug effects
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Drug Resistance
  • Equipment Design
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Artery / innervation*
  • Sympathectomy / adverse effects
  • Sympathectomy / instrumentation*
  • Time Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents