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Original Research

Open Access

Safety and efficacy of renal sympathectomy in ablation of hypertension complicated with atrial fibrillation

  • Yongzhong Zhang1
  • Lin Zhao1
  • Xiaoshu Yin1
  • Xiaoping Wu2

1Department of Vasculocardiology, Ganzhou City People’s Hospital, 341000 Ganzhou, Jiangxi, China

2Department of Neurology, Taizhou Central Hospital (Taizhou University Affiliated Hospital), 318000 Taizhou, Zhejiang, China

DOI: 10.22514/sv.2022.015 Vol.18,Issue 2,March 2022 pp.130-136

Submitted: 29 October 2021 Accepted: 17 December 2021

Published: 08 March 2022

*Corresponding Author(s): Xiaoping Wu E-mail: wuxiaoping_666@163.com

Abstract

At present, there is limited data on the effect of renal sympathectomy combined with pulmonary vein isolation on hypertensive patients with atrial fibrillation. The purpose of this study was to explore the efficacy and safety of renal sympathectomy combined with ablation in the treatment of hypertension with atrial fibrillation. A comprehensive literature search was conducted on the treatment of hypertension complicated with atrial fibrillation. Comparing the clinical data of renal sympathetic denervation (RSDN)+pulmonary vein isolation (PVI) with that of PVI alone, we analyzed recurrence of postoperative atrial fibrillation (AF) as main outcome. Classification variables were represented by risk ratio (RR), continuous variables as average difference (MD) and 95% confidence interval (CI). A total of 7 eligible studies were included, including 734 patients (RSDN+PVI group: 340 cases; PVI group: 394 cases). The follow-up period was one year or more. Compared with the separate PVI (56%), the recurrence rate of AF in RSDN+PVI group (32%) decreased significantly (RR: 0.60, 95% CI: 0.50, 0.71, p < 0.001). RSDN+PVI increased the operation time (Weighted Mean Difference (WMD): 24.92, 95% CI: 20.27, 29.57, p < 0.001), but did not increase the fluoroscopy time (WMD: 1.58, 95% CI: −7.50, 10.66, p = 0.73). Six months after operation, the glomerular filtration rate in RSDN+PVI group was significantly higher than that in PVI group (WMD: 6.17, 95% CI: 3.09, 9.24, p < 0.001). The control of systolic blood pressure and diastolic blood pressure in RSDN+PVI group was significantly better than that in PVI group (WMD: −9.55, 95% CI: −16.27, −2.84, p = 0.005; WMD: −6.11, 95%CI: −10.72, −1.50, p = 0.009). There was no significant difference in complications between the two groups (RR: 0.85, 95% CI: 0.32, 2.21, p = 0.73). The heterogeneity of clinical outcome was very low in atrial fibrillation and complications (I2 = 0). PVI combined with RSDN is a feasible and safe interventional therapy option for patients with hypertension complicated with atrial fibrillation, which can effectively reduce the burden of atrial fibrillation and improve the control of blood pressure and prevent further renal damage.


Keywords

Hypertensive; Atrial fibrillation; Ablation; Renal sympathectomy


Cite and Share

Yongzhong Zhang,Lin Zhao,Xiaoshu Yin,Xiaoping Wu. Safety and efficacy of renal sympathectomy in ablation of hypertension complicated with atrial fibrillation. Signa Vitae. 2022. 18(2);130-136.

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