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Renal Sympathetic Denervation Provides Ventricular Rate Control But Does Not Prevent Atrial Electrical Remodeling During Atrial Fibrillation

Renal denervation (RDN) reduces renal efferent and afferent sympathetic activity thereby lowering blood pressure in resistant hypertension. The effect of modulation of the autonomic nervous system by RDN on atrial electrophysiology and ventricular rate control during atrial fibrillation (AF) is unkn... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2013-01, Vol.61 (1), p.225-231
Main Author: Linz, Dominik
Other Authors: Mahfoud, Felix , Schotten, Ulrich , Ukena, Christian , Hohl, Mathias , Neuberger, Hans-Ruprecht , Wirth, Klaus , Bohm, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: American Heart Association, Inc
ID: ISSN: 0194-911X
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recordid: cdi_proquest_miscellaneous_1239059672
title: Renal Sympathetic Denervation Provides Ventricular Rate Control But Does Not Prevent Atrial Electrical Remodeling During Atrial Fibrillation
format: Article
creator:
  • Linz, Dominik
  • Mahfoud, Felix
  • Schotten, Ulrich
  • Ukena, Christian
  • Hohl, Mathias
  • Neuberger, Hans-Ruprecht
  • Wirth, Klaus
  • Bohm, Michael
subjects:
  • Aged
  • Animals
  • Arterial hypertension. Arterial hypotension
  • atrial fibrillation
  • Atrial Fibrillation - physiopathology
  • Atrial Fibrillation - surgery
  • Atrial Function - physiology
  • Atrioventricular Node - physiopathology
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Pressure - physiology
  • Cardiology. Vascular system
  • electrical remodeling
  • Fundamental and applied biological sciences. Psychology
  • Heart Atria - physiopathology
  • Humans
  • Hypertension - physiopathology
  • Hypertension - surgery
  • Kidney - innervation
  • Kidney - physiopathology
  • Kidney - surgery
  • Male
  • Medical sciences
  • rate control
  • Refractory Period, Electrophysiological
  • renal denervation
  • Swine
  • Sympathectomy
  • Sympathetic Nervous System - physiopathology
  • symplicity
  • Vertebrates: urinary system
ispartof: Hypertension (Dallas, Tex. 1979), 2013-01, Vol.61 (1), p.225-231
description: Renal denervation (RDN) reduces renal efferent and afferent sympathetic activity thereby lowering blood pressure in resistant hypertension. The effect of modulation of the autonomic nervous system by RDN on atrial electrophysiology and ventricular rate control during atrial fibrillation (AF) is unknown. Here we report a reduction of ventricular heart rate in a patient with permanent AF undergoing RDN. Subsequently, we investigated the effect of RDN on AF-induced shortening of atrial effective refractory period, AF inducibility, and ventricular rate control during AF maintained by rapid atrial pacing in 12 pigs undergoing RDN (n=7) or sham procedure (n=5). During sinus rhythm, RDN reduced heart rate (RR-interval, 708±12 versus 577±19 ms; P=0.0021) and increased atrioventricular node conduction time (PQ-interval, 112±12 versus 88±9 ms; P=0.0001). Atrial tachypacing for 30 minutes increased AF inducibility and decreased AF cycle length. This was not influenced by RDN. RDN reduced ventricular rate during AF episodes by ≈24% (119±9 versus 158±19 bpm; P=0.0001). AF episodes were shorter after RDN compared with sham (12±3 versus 34±4 s; P=0.0091), but atrial effective refractory period was not modified by RDN. RDN reduced heart rate and reduced atrioventricular node conduction time during sinus rhythm and provided rate control during AF. AF-induced atrial electrical remodeling, AF inducibility, and AF cycle length were not modified, but duration of AF episodes was shorter after RDN. Modulation of the autonomic nervous system by RDN might provide rate control and reduce susceptibility to AF. Whether RDN may provide rate control in a larger number of patients with AF deserves further clinical studies.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleRenal Sympathetic Denervation Provides Ventricular Rate Control But Does Not Prevent Atrial Electrical Remodeling During Atrial Fibrillation
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creatorcontribLinz, Dominik ; Mahfoud, Felix ; Schotten, Ulrich ; Ukena, Christian ; Hohl, Mathias ; Neuberger, Hans-Ruprecht ; Wirth, Klaus ; Bohm, Michael
descriptionRenal denervation (RDN) reduces renal efferent and afferent sympathetic activity thereby lowering blood pressure in resistant hypertension. The effect of modulation of the autonomic nervous system by RDN on atrial electrophysiology and ventricular rate control during atrial fibrillation (AF) is unknown. Here we report a reduction of ventricular heart rate in a patient with permanent AF undergoing RDN. Subsequently, we investigated the effect of RDN on AF-induced shortening of atrial effective refractory period, AF inducibility, and ventricular rate control during AF maintained by rapid atrial pacing in 12 pigs undergoing RDN (n=7) or sham procedure (n=5). During sinus rhythm, RDN reduced heart rate (RR-interval, 708±12 versus 577±19 ms; P=0.0021) and increased atrioventricular node conduction time (PQ-interval, 112±12 versus 88±9 ms; P=0.0001). Atrial tachypacing for 30 minutes increased AF inducibility and decreased AF cycle length. This was not influenced by RDN. RDN reduced ventricular rate during AF episodes by ≈24% (119±9 versus 158±19 bpm; P=0.0001). AF episodes were shorter after RDN compared with sham (12±3 versus 34±4 s; P=0.0091), but atrial effective refractory period was not modified by RDN. RDN reduced heart rate and reduced atrioventricular node conduction time during sinus rhythm and provided rate control during AF. AF-induced atrial electrical remodeling, AF inducibility, and AF cycle length were not modified, but duration of AF episodes was shorter after RDN. Modulation of the autonomic nervous system by RDN might provide rate control and reduce susceptibility to AF. Whether RDN may provide rate control in a larger number of patients with AF deserves further clinical studies.
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subjectAged ; Animals ; Arterial hypertension. Arterial hypotension ; atrial fibrillation ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Atrial Function - physiology ; Atrioventricular Node - physiopathology ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Cardiology. Vascular system ; electrical remodeling ; Fundamental and applied biological sciences. Psychology ; Heart Atria - physiopathology ; Humans ; Hypertension - physiopathology ; Hypertension - surgery ; Kidney - innervation ; Kidney - physiopathology ; Kidney - surgery ; Male ; Medical sciences ; rate control ; Refractory Period, Electrophysiological ; renal denervation ; Swine ; Sympathectomy ; Sympathetic Nervous System - physiopathology ; symplicity ; Vertebrates: urinary system
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descriptionRenal denervation (RDN) reduces renal efferent and afferent sympathetic activity thereby lowering blood pressure in resistant hypertension. The effect of modulation of the autonomic nervous system by RDN on atrial electrophysiology and ventricular rate control during atrial fibrillation (AF) is unknown. Here we report a reduction of ventricular heart rate in a patient with permanent AF undergoing RDN. Subsequently, we investigated the effect of RDN on AF-induced shortening of atrial effective refractory period, AF inducibility, and ventricular rate control during AF maintained by rapid atrial pacing in 12 pigs undergoing RDN (n=7) or sham procedure (n=5). During sinus rhythm, RDN reduced heart rate (RR-interval, 708±12 versus 577±19 ms; P=0.0021) and increased atrioventricular node conduction time (PQ-interval, 112±12 versus 88±9 ms; P=0.0001). Atrial tachypacing for 30 minutes increased AF inducibility and decreased AF cycle length. This was not influenced by RDN. RDN reduced ventricular rate during AF episodes by ≈24% (119±9 versus 158±19 bpm; P=0.0001). AF episodes were shorter after RDN compared with sham (12±3 versus 34±4 s; P=0.0091), but atrial effective refractory period was not modified by RDN. RDN reduced heart rate and reduced atrioventricular node conduction time during sinus rhythm and provided rate control during AF. AF-induced atrial electrical remodeling, AF inducibility, and AF cycle length were not modified, but duration of AF episodes was shorter after RDN. Modulation of the autonomic nervous system by RDN might provide rate control and reduce susceptibility to AF. Whether RDN may provide rate control in a larger number of patients with AF deserves further clinical studies.
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1Animals
2Arterial hypertension. Arterial hypotension
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4Atrial Fibrillation - physiopathology
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6Atrial Function - physiology
7Atrioventricular Node - physiopathology
8Biological and medical sciences
9Blood and lymphatic vessels
10Blood Pressure - physiology
11Cardiology. Vascular system
12electrical remodeling
13Fundamental and applied biological sciences. Psychology
14Heart Atria - physiopathology
15Humans
16Hypertension - physiopathology
17Hypertension - surgery
18Kidney - innervation
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24Refractory Period, Electrophysiological
25renal denervation
26Swine
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titleRenal Sympathetic Denervation Provides Ventricular Rate Control But Does Not Prevent Atrial Electrical Remodeling During Atrial Fibrillation
authorLinz, Dominik ; Mahfoud, Felix ; Schotten, Ulrich ; Ukena, Christian ; Hohl, Mathias ; Neuberger, Hans-Ruprecht ; Wirth, Klaus ; Bohm, Michael
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abstractRenal denervation (RDN) reduces renal efferent and afferent sympathetic activity thereby lowering blood pressure in resistant hypertension. The effect of modulation of the autonomic nervous system by RDN on atrial electrophysiology and ventricular rate control during atrial fibrillation (AF) is unknown. Here we report a reduction of ventricular heart rate in a patient with permanent AF undergoing RDN. Subsequently, we investigated the effect of RDN on AF-induced shortening of atrial effective refractory period, AF inducibility, and ventricular rate control during AF maintained by rapid atrial pacing in 12 pigs undergoing RDN (n=7) or sham procedure (n=5). During sinus rhythm, RDN reduced heart rate (RR-interval, 708±12 versus 577±19 ms; P=0.0021) and increased atrioventricular node conduction time (PQ-interval, 112±12 versus 88±9 ms; P=0.0001). Atrial tachypacing for 30 minutes increased AF inducibility and decreased AF cycle length. This was not influenced by RDN. RDN reduced ventricular rate during AF episodes by ≈24% (119±9 versus 158±19 bpm; P=0.0001). AF episodes were shorter after RDN compared with sham (12±3 versus 34±4 s; P=0.0091), but atrial effective refractory period was not modified by RDN. RDN reduced heart rate and reduced atrioventricular node conduction time during sinus rhythm and provided rate control during AF. AF-induced atrial electrical remodeling, AF inducibility, and AF cycle length were not modified, but duration of AF episodes was shorter after RDN. Modulation of the autonomic nervous system by RDN might provide rate control and reduce susceptibility to AF. Whether RDN may provide rate control in a larger number of patients with AF deserves further clinical studies.
copHagerstown, MD
pubAmerican Heart Association, Inc
pmid23150501
doi10.1161/HYPERTENSIONAHA.111.00182
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