Catheter Ablation -> Ventricular Arrhythmias -> Experimental methods D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-089 - Catheter-based Radiofrequency Ablation To Denervate Renal Arteries For The Electrical Storm Treatment (ID 1359)

 F.G. Rzaev: Nothing relevant to disclose.
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Background: Electrical storm (ES) is a potentially lethal state developing in 4-28% of ICD patients. Neuroaxial modulation is used to decrease arrhythmogenic predisposition of ventricular myocardium to trigger and maintain ventricular arrhythmias. We used catheter denervation of renal arteries (RAD) in addition to standard care to improve the results of ES treatment.
Objective: To analyze in-hospital number of ventricular tachycardia (VT) episodes and mid-term survival after RAD in the ES population.
Methods: Pts admitted to the CCU for more than 3 sustained VT episodes or more than 3 appropriate ICD shocks during the 24h period in 2017-18 were enrolled. Demographic, echocardiographic, ICD check up, renal arteries anatomy and mid-term mortality/transplant data were retrospectively analyzed.
Results: Eleven pts (all male, age 69±9 years) were included. Seven pts (73%) had CAD, 3 pts (27%) - DCM. Echocardiography revealed LVEF 28±8%, and LV EDV - 226±91 ml. Time from ICD implantation to ES onset was from 4 mos to 13 yrs. In 5 pts RDN was performed without VT ablation, in 3 pts - prior to VT ablation, in 2 - after VT ablation and in 1 pt - both RDN and VT ablation were performed during the same procedure. Mean number of renal arteries was 2,5 per pt. Mean number of ablations was 4,8 per artery. The power was 2 to 11 Wt and lesion duration was 90 sec. Dramatic decrease in the number of VT episodes (49±52 vs. 6±2) was found in 6/11 pts directly after RDN procedure. In-hospital rhythm control was accessed in 10/11 pts, 1 pt with DCM was transferred for heart transplant due to recurrence of VT after VT ablation and RAD (excluded from survival analysis). There were no RDN procedure related complications in this group of pts. In mean 6 mos of follow-up 9/10 pts are free from ES recurrence, 1/10 was lost for the follow up.
Conclusion: Catheter renal artery denervation can be effective and safe additional procedure to treat ES patients. Larger multi-center randomized trials are warranted.