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Renal denervation in patients who do not respond to cardiac resynchronization therapy

Päivi Pietilä-Effati1, Mathias Höglund1, Aki Käräjämäki2

  • 1Cardiac Unit, Vaasa Central Hospital, Vaasa, Finland.

Scandinavian Cardiovascular Journal : SCJ
|May 19, 2022
PubMed

Insights

Renal denervation (RDN) did not improve outcomes for heart failure patients who did not respond to cardiac resynchronization therapy (CRT). This study found RDN could not reverse heart failure progression in severe cases.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) benefits approximately two-thirds of advanced heart failure (HF) patients.
  • A significant portion of HF patients are non-responders to CRT.
  • Sympathetic nervous system overactivity is linked to advanced HF and worsens hemodynamic status.

Purpose of the Study:

  • To investigate if renal denervation (RDN) could benefit CRT non-responders by controlling sympathetic overactivity.
  • To evaluate the efficacy of RDN in improving outcomes for patients with advanced heart failure (NYHA Class III-IV) who do not respond to CRT.

Main Methods:

  • The HeartF-RDN study (ClinicalTrials.gov. NCT02638324) enrolled patients with advanced heart failure (NYHA Class III-IV) who were non-responders to CRT.
  • Renal denervation (RDN) was performed to modulate sympathetic nervous system activity.

Main Results:

  • Renal denervation (RDN) did not reverse the progression of heart failure in patients with NYHA Class III-IV symptoms.
  • The study did not demonstrate a benefit of RDN in this specific patient population.

Conclusions:

  • Renal denervation (RDN) is not effective in reversing heart failure progression in non-responders to cardiac resynchronization therapy (CRT) with advanced symptoms.
  • Further research may be needed to explore alternative strategies for CRT non-responders.

Keywords:
6-minute walking testCRT nonresponderCardiac resynchronization therapyheart failurerenal sympathetic denervation

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