Long-Term Electrocardiographic Changes Following Renal Denervation-Left Ventricular Mass and Arrhythmia Burden

Renal denervation (RDN) is an adjunct therapy for resistant hypertension, reducing blood pressure (BP) by inhibiting both afferent sensory and efferent sympathetic renal nerve activity. The resulting reduction in central sympathetic outflow including that directed toward the heart may beneficially impact cardiac remodeling, left ventricular hypertrophy (LVH) and atrial fibrillation (AF). RDN has been shown to reduce left ventricular mass and AF burden but long-term data is sparse. Forty patients (72.5% male, 69.2 ± 9.6 years) underwent 12-lead ECG at baseline prior to RDN and at a mean long-term follow-up (LTFU) of 8.3 ± 0.9 years post-intervention. A 24-h ambulatory blood pressure monitor (ABPM) was obtained at both time points. Cornell voltage indices were calculated at baseline and LTFU, then converted to left ventricular mass based on validated formulae accounting for sex. ECGs underwent cardiologist review for determination of AF at both time-points. There was no difference in Cornell voltages or left ventricular mass index (LVMI) between baseline and long-term follow-up in neither males (p = 0.89) nor females (p = 0.91). BP lowering at LTFU was correlated with a more pronounced reduction in LVMI (r = 0.50, p = 0.0011) No change was observed in the incidence of atrial fibrillation between baseline or long-term follow-up (p = 0.99). There was no reduction in mean Cornell voltage or LVMI across the cohort between baseline and long-term follow-up. However, changes in ambulatory systolic BP correlated with reduction in LVMI suggestive of an RDN-induced BP dependent long-term reduction in LVMI out to eight years post-RDN.