INTRODUCTION.
This meta-analysis of randomized controlled trials (RCT) was permormed to compare clinical outcomes following renal denervation (RDN) in drug-resistant hypertensive patients with atrial fibrillation (AF).
METHODS
Data collection: We applied the methods recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched Pubmed, and the Cochrane Central Register for randomized controlled trials (RCT) that evaluated AF catheter ablation associated with RDN compared with AF catheter ablation alone, in drug-resistant hypertensive patients.
Outcome: The primary outcomes was the rate of AF recurrence throughout the follow-up period.
Statistical Analysis: The analyses were performed using RevMan version 5.3. The results are presented as odds ratios (OR) for dichotomous outcomes (Inverse variance method, random effect model) with 95% confidence interval (CI).
RESULTS
Five full texts met inclusion criteria. A total of 531 patients were included (269 patients randomized to catheter ablation and RDN and 262 patients randomized to catheter ablation alone), with a mean follow-up of 16.8 months.
We found a significantly lower number of patients with AF recurrence in the AF catheter ablation with RDN group (83/269), respect to AF catheter ablation alone (125/262) at the end of the follow-up (OR 0.51 (0.35-0.72) p 0.0002)
RDN procedure in these trials was was safe with an overall compilcation rate of 6.32%
CONCLUSIONS
Combined AF catheter ablation and RDN is beneficial for patients with drug resistant hypertension and AF reducing the risk of AF recurrence.