Renal Denervation for the Treatment of Ventricular Arrhythmias: A
Systematic Review and Meta-Analysis
Abstract
Introduction Ventricular arrhythmias (VAs) are a major cause of
morbidity and mortality in patients with heart disease. Recent studies
evaluated the effect of renal denervation (RDN) on the occurrence of
VAs. We conducted a systematic review and meta-analysis to determine the
efficacy and safety of this procedure. Methods and results A systematic
search of the literature was performed to identify studies that
evaluated the use of RDN for the management of VAs. Primary outcomes
were reduction in the number of VAs and implantable
cardioverter-defibrillator (ICD) therapies. Secondary outcomes were
changes in blood pressure and renal function. Ten studies (152 patients)
were included in the meta-analysis. RDN was associated with a reduction
in the number of VAs, ATP (antitachycardia pacing), ICD shocks and
overall ICD therapies of 3.53events/patient/month (95%CI=-5.48 to
-1.57), 2.86events/patient/month (95%CI=-4.09 to -1.63),
2.04events/patient/month (95%CI=-2.12 to -1.97), and
2.68events/patient/month (95%CI=-3.58 to -1.78), respectively.
Periprocedural adverse events occurred in 1.23% of patients and no
significant changes were seen in blood pressure or renal function.
Conclusions In patients with refractory VAs, RDN was associated with a
reduction in the number of VAs and ICD therapies, and was shown to be a
safe procedure. KEYWORDS: Renal denervation, ventricular arrhythmias,
implantable cardioverter-defibrillator, antitachycardia pacing, ICD
shocks.