Catheter-based Renal Sympathetic Denervation - Long-term Symplicity™ Renal Denervation Clinical Evidence, New Data and Future Perspectives

Article on Catheter-based Renal Sympathetic Denervation - Long-term Symplicity™ Renal Denervation Clinical Evidence, New Data and Future Perspectives

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Based on Presentations at a Medtronic Sponsored Symposium held at EuroPCR 2013, Paris, France, on 21 May 2013

The article was reviewed for accuracy by the presenters:

Felix Mahfoud,1 Roland Schmieder,2 Justin Davies,3 David E Kandzari,4 Joachim Weil5 and Robert Whitbourn6 

1. Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany; 

2. Medizinische Klinik IV, Universitätsklinikum Erlangen, Erlangen, Germany; 

3. Consultant Cardiologist, Hammersmith Hospital, Imperial College London, London, UK; 

4. Chief Scientific Officer, Director, Interventional Cardiology, Piedmont Heart Institute, Atlanta, Georgia, US; 

5. CardioMed Herzzentrum Nord, Sana Klinikum Lübeck, Akademisches Lehrkrankenhaus der Universität zu Lübeck, Lübeck, Germany; 

6. Director, Cardiac Catheterization Labs and Coronary Intervention, The Cardiovascular Research Centre, University of Melbourne and Australian Catholic University, Melbourne, Australia 

Hypertension is one of the most prevalent chronic diseases worldwide and the incidence of resistant hypertension is increasing. Catheter-based renal denervation (RDN) offers a new approach to reaching blood pressure goals by targeting the renal nerves. The technique has demonstrated signicant and sustained reductions in blood pressure (BP) in the Symplicity HTN-1 and Symplicity HTN-2 clinical trials. The Global SYMPLICITY Registry aims to demonstrate safety and effectiveness in a 'real-world' patient population. Real-world RDN experience has emphasised that patient selection is crucial to successful outcomes; a multidisciplinary referral network is recommended to increase awareness of the procedure and identify patients who are likely to respond best to RDN. Further advances in catheter technology have led to the development of the multi-electrode Symplicity Spyral™ multi-electrode catheter; preliminary data from the feasibility study using the Symplicity Spyral catheter indicate clinical efcacy and procedural safety with reduced procedure times. The Symplicity Spyral catheter is not yet commercially available. The indications of RDN may also expand beyond resistant hypertension - encouraging data have been seen in patients with moderate treatment resistant hypertension. Furthermore, RDN may be benecial in other clinical states characterised by sympathetic nervous system overactivation including heart failure and chronic kidney disease. Additional data are needed to evaluate the efcacy of RDN in these disease states.


Katrina Mountfort : Orgnanization : Medical Writer, Radcliffe Cardiology

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