Endocardial catheter ablation is a widely used
alternative for the treatment of atrial fibrillation (AF). Despite technical
improvements, and increased understanding of mechanism, and acquired technical
experience over many years, the results are not yet optimal. This results in an
ongoing search for new therapeutic approaches.
Because cardiac sympathetic drive is
potentially responsible for triggering and sustaining AF, modulation of
sympathetic tone has been proposed as a viable treatment objective. The early
attempts to test this concept were limited by nature=highly intrusive
techniques but new approaches and targets have been recently introduced.
Specifically, renal nerve ablation has been introduced and the first attempts
to employ this technique for treatment of cardiac arrhythmias give as a promise
of new therapeutic avenues in near future.
This review focuses
on the possible role of renal denervation in treatment of atrial fibrillation,
the contemporary evidence supporting this approach, and the ongoing trials to
establish its therapeutic role.
Credits: Jedrzej Kosiuk, MD; Evgeny Pokushalov, MD,Phd; Sebastian Hilbert, MD; Gerhard Hindricks, MD; Andreas Bollmann, MD, PhD; Jonathan S. Steinberg, MD