Renal Denervation (RDN)
RDN has been hypothesized to decrease AF recurrence rate by ablating the
renal sympathetic efferent and afferent nerves that interact with the
central autonomic nervous system. The ERADICATE-AF trial (Effect of
Renal Denervation and Catheter Ablation vs Catheter Ablation Alone on
Atrial Fibrillation Recurrence Among Patients with Paroxysmal Atrial
Fibrillation and Hypertension) analyzed 302 patients with PAF and showed
improved AF freedom with the addition of RDN to PVI (120). Two recent
meta-analyses also supported the idea of additional RDN (121,122).
However, these studies have been primarily performed on patients with
PAF. The SYMPLICITY AF trial (Renal Nerve Denervation in Patients with
Hypertension and Paroxysmal and Persistent Atrial Fibrillation;
NCT02064764) is a multicenter trial which explores the efficacy and
safety of additional RDN over PVI.