Renal denervation for the treatment of ventricular arrhythmias: A systematic review and meta‐analysis

• Published in: Journal of cardiovascular electrophysiology Vol. 32; no. 5; pp. 1430 - 1439
• Main Authors: Prado, Gabriela M., Mahfoud, Felix, Lopes, Renato D., Moreira, Dalmo A. R., Staico, Rodolfo, Damiani, Lucas P., Ukena, Christian, Armaganijan, Luciana V.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2021
• Subjects: Ablation; Adverse events; antitachycardia pacing; Arrhythmia; Blood pressure; Cardiac arrhythmia; Coronary artery disease; Denervation; Heart diseases; ICD shocks; implantable cardioverter–defibrillator; Kidneys; Meta-analysis; Morbidity; Patients; renal denervation; Renal function; Systematic review; Ventricle; ventricular arrhythmias; ICD shocks; renal denervation; antitachycardia pacing; ventricular arrhythmias; implantable cardioverter-defibrillator
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.15004

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, antitachycardia pacing, ICD shocks, and overall ICD therapies of 3.53 events/patient/month (95% confidence interval [CI] = −5.48 to −1.57), 2.86 events/patient/month (95% CI = −4.09 to −1.63), 2.04 events/patient/month (95% CI = −2.12 to −1.97), and 2.68 events/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.