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Renal sympathetic denervation for treatment of electrical storm: first-in-man experience

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Abstract

Introduction

Sympathetic activity plays an important role in the pathogenesis of ventricular tachyarrhythmia. Catheter-based renal sympathetic denervation (RDN) is a novel treatment option for patients with resistant hypertension, proved to reduce local and whole-body sympathetic activity.

Methods

Two patients with chronic heart failure (CHF) (non-obstructive hypertrophic and dilated cardiomyopathy, NYHA III) suffering from therapy resistant electrical storm underwent therapeutic renal denervation. In both patients, RDN was conducted with agreement of the local ethics committee and after obtaining informed consent.

Results

The patient with hypertrophic cardiomyopathy had recurrent monomorphic ventricular tachycardia despite extensive antiarrhythmic therapy, following repeated endocardial and epicardial electrophysiological ablation attempts to destroy an arrhythmogenic intramural focus in the left ventricle. The second patient, with dilated nonischemic cardiomyopathy, suffered from recurrent episodes of polymorphic ventricular tachycardia and ventricular fibrillation. The patient declined catheter ablation of these tachycardias. In both patients, RDN was performed without procedure-related complications. Following RDN, ventricular tachyarrhythmias were significantly reduced in both patients. Blood pressure and clinical status remained stable during the procedure and follow-up in these patients with CHF.

Conclusion

Our findings suggest that RDN is feasible even in cardiac unstable patients. Randomized controlled trials are urgently needed to study the effects of RD in patients with electrical storm and CHF.

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Acknowledgments

C. Ukena, F. Mahfoud and M. Böhm are supported by the Ministry of Science and Economy of the Federal State of the Saarland. C. Ukena and M. Böhm are supported by the Deutsche Forschungsgemeinschaft (KFO 196). F. Mahfoud is supported by the Deutsche Hochdruckliga.

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Authors and Affiliations

  1. Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Kirrberger Str. 1, 66421, Homburg/Saar, Germany

    Christian Ukena, Felix Mahfoud, Hans-Ruprecht Neuberger & Michael Böhm

  2. Medizinische Klinik III, Eberhard Karls Universität, 72074, Tübingen, Germany

    Axel Bauer, Jürgen Schreieck, Christian Eick & Meinrad Gawaz

  3. The Ohio State University, Columbus, OH, USA

    Paul A. Sobotka

Authors
  1. Christian Ukena
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  2. Axel Bauer
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  3. Felix Mahfoud
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  4. Jürgen Schreieck
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  5. Hans-Ruprecht Neuberger
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  6. Christian Eick
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  7. Paul A. Sobotka
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  8. Meinrad Gawaz
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  9. Michael Böhm
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Corresponding author

Correspondence to Christian Ukena.

Additional information

C. Ukena and A. Bauer contributed equally.

C. Ukena, F. Mahfoud and M. Böhm received speakers’ honoria from Medtronic Ardian.

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Ukena, C., Bauer, A., Mahfoud, F. et al. Renal sympathetic denervation for treatment of electrical storm: first-in-man experience. Clin Res Cardiol 101, 63–67 (2012). https://doi.org/10.1007/s00392-011-0365-5

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  • DOI: https://doi.org/10.1007/s00392-011-0365-5

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