Renal sympathetic denervation guided by renal nerve stimulation to treat ventricular arrhythmia in CKD patients with ICD

Chronic kidney disease (CKD) patients on stage 4 present greater risk rates for malignant ventricular arrhythmia events. This study examined patients with CKD in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the...

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Bibliographic Details
Published in:Oncotarget 2017-06, Vol.8 (23), p.37296-37307
Main Authors: Kiuchi, Márcio Galindo, Chen, Shaojie, Paz, Luis Marcelo Rodrigues, Pürerfellner, Helmut
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arrhythmias, Cardiac - complications
Arrhythmias, Cardiac - surgery
Cohort Studies
Defibrillators, Implantable - statistics & numerical data
Electric Countershock
Female
Follow-Up Studies
Humans
Kidney - innervation
Kidney - surgery
Male
Middle Aged
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - surgery
Research Paper
Sympathectomy
Treatment Outcome
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Summary:Chronic kidney disease (CKD) patients on stage 4 present greater risk rates for malignant ventricular arrhythmia events. This study examined patients with CKD in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, "Anti-tachycardia Therapy Pacing" (ATP) and shock events during the 18 months of follow-up and compare the incidence and severity of these at different stages of CKD, mainly in patients with CKD stage 4 underwent renal sympathetic denervation (RSD) guided by renal nerve stimulation (RNS). One hundred and fifteen patients were evaluated once every three months till 18 months of follow-up. The arrhythmic events were assessed at each follow-up visit. Comparing the groups, we can see the number of ATP and shock events recorded by ICD during 18 months of follow-up, and differences in the number of therapeutic events between the various stages of CKD. The hazard ratio (HR), 95% confidence interval (CI) and P value for ATP and shock events between all the CKD stages were evaluated by the log-rank/Mantel-Haenszel test. At the 18th month of follow-up, 75% of patients with CKD stage 4 received ATP, and 70% were treated with shock while only 20% of the subjects with CKD stage 4 that were submitted to RSD received ATP and 20% were treated with shock, P
ISSN:1949-2553
1949-2553
DOI:10.18632/oncotarget.16278