Heart rate variability in a patient after percutaneous renal denervation: a case report

Taufiq M. Baksh, Mukta P. Bidikar

Abstract


The overactivity of sympathetic component of autonomic nervous system is implicated in the genesis and progression of hypertension. We report the heart rate variability (HRV) of a patient after renal denervation for treatment of medically resistant hypertension. Catheter based renal denervation done for treatment of resistant hypertension reduces blood pressure by reducing the central sympathetic drive. In the present study we found a significant decrease in low frequency component of HRV in one month follow-up period after the procedure. We propose a simple, non-invasive 5-minute HRV could be a predictor of effective renal sympathetic denervation.


Keywords


Heart rate variability, Renal denervation, Resistant hypertension

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References


Grisk O, Rettig R. Interactions between the sympathetic nervous system and the kidneys in arterial hypertension. Cardiovascular research 2004; 61:238-246.

Kobori H, Nangaku M, Navar LG, Nishiyama A. The intrarenal renin-angiotensin system: from physiology to the pathobiology of hypertension and kidney disease. Pharmacological Reviews 2007;59:251-287.

Malpas SC. Sympathetic nervous system overactivity and its role in the development of cardiovascular disease. Physiological Reviews 2010; 90: 513-557.

Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension 2011;57(5):911-917.

Esler MD, Krum H, Schlaich M, Schmeider RE, Bohm M, Sobotka PA, et al. Renal sympathetic denervation for treatment of drug resistant hypertension: one year results from the Symplicity HTN-2 randomized, controlled trial. Circulation 2012;126(25): 976-82.

Schlaich MP, Sobotka PA, Krum H, Whitbourn R, Walton A, Esler MD. Renal denervation as a therapeutic approach for hypertension: novel implications for an old concept. Hypertension 2009;54(6):1195-1201.

Schlaich MP, Sobotka PA, Krum H, Lambert E, Esler MD. Renal sympathetic nerve ablation for uncontrolled hypertension. N Engl J Med 2009; 361;9:932-934.

Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation. 1996 March 1;93(5):1043-1065.

Himmel F, Weil J, Reppel M, Mortensen K, Franzen, K, Ansgar L, Schunkert H, Bode F. (2012), Improved Heart Rate Dynamics in Patients Undergoing Percutaneous Renal Denervation. J Clin Hypertens. 2012;14: 654-5.