Meta-Analysis of Renal Denervation Therapy During Pulmonary Vein Isolation in Atrial Fibrillation

Pulmonary vein isolation (PVI) has been established as a first-line therapy for symptomatic atrial fibrillation (AF) in selected patients with symptomatic AF and in those whose antiarrhythmic drug treatment failed. However, AF recurrence rates after PVI remain high, prompting the exploration of adjunct therapies, such as renal denervation (RDN), to improve outcomes. This meta-analysis aimed to assess the efficacy of RDN as an adjunct to PVI in reducing AF recurrence. A comprehensive search of randomized controlled trials comparing RDN plus PVI with PVI alone was conducted, yielding 9 studies with 955 patients. The primary end point was freedom from AF at 12 months. The results showed that 61.7% of patients in the RDN+PVI group were free from AF compared with 52.6% in the PVI alone group (risk ratio 1.32, 95% confidence interval 1.07 to 1.61, I² = 48%). These findings support the potential of RDN to enhance PVI efficacy; however, further large-scale randomized controlled trials with standardized methods and longer follow-up periods are necessary to confirm these results and establish the role of RDN in the treatment of AF.