Meta-Analysis of Renal Denervation Therapy During Pulmonary Vein Isolation in Atrial Fibrillation.

Autor: Salah HM; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina., Rommel KP; Department of Cardiology, University Medical Center Mainz and German Center for Cardiovascular Research, Mainz, Germany., Kresoja KP; Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Mahfoud F; Department of Cardiology, University Heart Center Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland., Lurz P; Department of Cardiology, University Medical Center Mainz and German Center for Cardiovascular Research, Mainz, Germany., Piccini JP; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina., Fudim M; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina. Electronic address: marat.fudim@duke.edu.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Nov 08; Vol. 236, pp. 20-22. Date of Electronic Publication: 2024 Nov 08.
DOI: 10.1016/j.amjcard.2024.11.001
Abstrakt: Pulmonary vein isolation (PVI) has been established as a first-line therapy for symptomatic atrial fibrillation (AF) in selected patients with symptomatic AF and in those whose antiarrhythmic drug treatment failed. However, AF recurrence rates after PVI remain high, prompting the exploration of adjunct therapies, such as renal denervation (RDN), to improve outcomes. This meta-analysis aimed to assess the efficacy of RDN as an adjunct to PVI in reducing AF recurrence. A comprehensive search of randomized controlled trials comparing RDN plus PVI with PVI alone was conducted, yielding 9 studies with 955 patients. The primary end point was freedom from AF at 12 months. The results showed that 61.7% of patients in the RDN+PVI group were free from AF compared with 52.6% in the PVI alone group (risk ratio 1.32, 95% confidence interval 1.07 to 1.61, I² = 48%). These findings support the potential of RDN to enhance PVI efficacy; however, further large-scale randomized controlled trials with standardized methods and longer follow-up periods are necessary to confirm these results and establish the role of RDN in the treatment of AF.
Competing Interests: Declaration of competing interest Dr. Kresoja has received travel support and consulting fees from Edwards Lifesciences. Prof. Mahfoud is supported by Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Forschungsgemeinschaft (SFB TRR219, Project-ID 322900939), and Deutsche Herzstiftung. Saarland University has received scientific support from Ablative Solutions, Medtronic (Milestone), and ReCor Medical. Until May 2024, FM has received speaker honoraria/consulting fees from Ablative Solutions, Amgen, Astra-Zeneca, Bayer, Boehringer Ingelheim, Inari, Medtronic, Merck, ReCor Medical, Servier, and Terumo. Prof. Lurz has received institutional fees and research grants from Abbott Vascular, Edwards Lifesciences, and ReCor, honoraria from Edwards Lifesciences, Abbott Medical, Innoventric, ReCor, and Boehringer Ingelheim and has stock options with Innoventric. Prof. Piccini is supported by R01AG074185 from the National Institutes of Aging. He also receives grants for clinical research from Abbott, the American Heart Association, Boston Scientific, iRhythm, and Philips and serves as a consultant to ABVF, Abbott, AbbVie, Boston Scientific, ElectroPhysiology Frontiers, Kardium, Medtronic Pharmaceuticals, Pacira, Sanofi, Philips, and Up-to-Date. Dr. Fudim has received consulting fees from Medtronic, ReCor, and SyMap. The remaining authors have no competing interests to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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