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Multi-Organ Denervation: The Past, Present and Future.

Syedah Aleena Haider^1,2, Ruth Sharif², Faisal Sharif^1,2

¹Department of Medicine, University of Galway, H91 TK33 Galway, Ireland.

Journal of Clinical Medicine

|April 26, 2025

Summary

Device-based sympathetic denervation offers a promising "always-on" therapeutic strategy for conditions like hypertension and heart failure, potentially overcoming limitations of traditional drug therapies.

Keywords:

autonomic nervous system cardiometabolic syndrome endovascular denervation hypertension sympathetic denervation sympathetic nervous system

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Area of Science:

Cardiovascular Science
Autonomic Neuroscience
Medical Device Technology

Background:

Sympathetic nervous system overactivity contributes to hypertension, hyperglycemia, heart failure, and rheumatoid arthritis.
Current pharmacotherapies have limitations including side effects and poor adherence.
Device-based multi-organ denervation presents an alternative therapeutic strategy with potential for continuous 24-hour benefit.

Purpose of the Study:

To review the evidence for targeted multi-organ sympathetic denervation.
To examine the link between sympathetic nervous system overactivity and cardiometabolic/inflammatory diseases.
To explore the potential of denervation beyond the renal arteries.

Main Methods:

Review of anatomical and functional aspects of the autonomic nervous system.
Analysis of existing literature on sympathetic nervous system overactivity and related conditions.
Evaluation of studies on renal denervation and other organ denervation techniques.

Main Results:

Renal denervation shows promise in reducing blood pressure and may benefit arrhythmias, glucose metabolism disorders, heart failure, chronic kidney disease, and obstructive sleep apnea.
Denervation of hepatic and splenic arteries, pulmonary artery, and carotid body may offer additional physiological benefits.
Simultaneous multi-organ denervation could enhance therapeutic effects.

Conclusions:

Multi-organ sympathetic denervation is a potential therapeutic approach for various diseases.
Further clinical trials are needed to optimize procedural techniques, efficacy, and safety.
This approach may offer continuous therapeutic benefits independent of medication compliance.