The need for and the challenges of measuring renal sympathetic nerve activity

Heart Rhythm. 2016 May;13(5):1166-1171. doi: 10.1016/j.hrthm.2016.01.018. Epub 2016 Jan 19.

Abstract

Renal denervation (RDN) was primarily developed to treat hypertension and is potentially a new method for treating arrhythmias. Because of the lack of a standardized protocol to measure renal sympathetic nerve activity, RDN is administered in a blind manner. This inability to assess efficacy at the time of treatment delivery may be a large contributor to the ambiguity of RDN outcomes reported in the hypertension literature. The advancement of RDN as a treatment of hypertension or arrhythmias will be hampered by the lack of delivery assessment, a deficiency that the cardiovascular electrophysiology community, with its expertise in recording and mapping, may have a role in addressing and overcoming. The development of endovascular recording of renal nerve action potentials may provide a useful accessory tool for RDN. Innovation in this area will be crucial as we as a community reconsider the therapeutic value of RDN.

Keywords: Cardiac arrhythmia; Hypertension; Neural recording; Renal denervation; Sympathetic nerve activity.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac* / physiopathology
  • Arrhythmias, Cardiac* / therapy
  • Humans
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Kidney / innervation
  • Outcome Assessment, Health Care
  • Sympathectomy / methods*
  • Sympathetic Nervous System / physiopathology*
  • Treatment Outcome