The Preliminary Result Of Renal Artery Denervation In Patients With Persistent Atrial Fibrillation And Hypertension Receiving Radiofrequency Catheter Ablation

Background:Radiofrequency catheter ablation of atrial fibrillation is thought one of the effective methods of treatment for drug refractory atrial fibrillation, however, the recurrence rate is still high,(paroxysmal atrial fibrillation:20-30%[4,5],persistent atrial fibrillation:30-40%[6]).Therefore, how to improve the event-free of patients with atrial fibrillation after taking Radiofrequency catheter ablation remains to be researched. Renal artery denervation is emerging in recent years used for the treatment of resistant hypertension of non-pharmaceutical methods[13-15], existing small sample study found renal artery denervation can further improve the success rate of radiofrequency ablation of atrial fibrillation[19]. By comparing the recurrence rate of patients with atrial fibrillation combined hypertension after the atrial fibrillation radiofrequency ablation with that after atrial fibrillation radiofrequency ablation+renal artery denervation, this study discusses the efficacy and safety of renal artery denervation in patients with persistent atrial fibrillation and hypertension receiving radiofrequency catheter ablation.Method:Continuously choose six patients of Sir Run Run Shaw Hospital with persistent atrial fibrillation and hypertension into group A. Continuously choose24patients of Sir Run Run Shaw Hospital with persistent atrial fibrillation and hypertension in the same period into group B. Group A:accept the treatment of persistent atrial fibrillation radiofrequency ablation and renal artery denervation, n=6.Group B:accept the treatment of persistent atrial fibrillation radiofrequency ablation, n=24.All patients accept1month,3month,6month,9month,12months of follow-up. Compare the recurrence rate and blood pressure change in the immediate and long-term between the two groups.Result:1case in6cases of group A reoccurs atrial fibrillation, recurrence rate was16.7%(1/6),8cases in24cases of group B reoccur atrial fibrillation (8/24), the recurrence rate was33.3%,(P=0.04).The mean systolic blood pressure of the group A is142.7+11.0mmHg before the operation, after the surgery is131.0+9.5mmHg,(P<0.05), the average decline in absolute value is11.7mmHg, there is significant difference, after3months and6months there were no statistical significance in systolic blood pressure compared with preoperative. But the mean diastolic blood pressure of the group A before the operation is96.2+2.6mmHg, after surgery is87.5+4.9mmHg (P<0.05) and after3months is81.2+6.9mmHg (P<0.05) and after6months is73.7+10.3mmHg (P<0.05).Conclusion:Renal artery denervation didn’t increase the risk of the operation of radiofrequency catheter ablation, may have a positive impact on persistent atrial fibrillation recurrences in patients with hypertension and persistent atrial fibrillation who underwent atrial fibrillation radiofrequency ablation. And renal artery denervation can have a positive effect on the diastolic blood pressure of patients, but it has no obvious improvement for systolic blood pressure.