HFS-guided Renal Ablation for Improving Outcome of Renal Denervation Procedure
Hypertension

About this trial
This is an interventional treatment trial for Hypertension focused on measuring Renal denervation, Ablation
Eligibility Criteria
Inclusion Criteria:
- Office-based systolic blood pressure of ≥140/90 mm Hg and <160/100 mm Hg (moderate resistant hypertension) or ≥160/100 mm Hg (severe resistant hypertension), despite treatment with 3 antihypertensive drugs (including a diuretic).
- A glomerular filtration rate ≥45 mL/min/1⋅73 m2, with modification of diet using a renal disease formula.
Exclusion Criteria:
- Secondary causes of hypertension
- Severe renal artery stenosis or dual renal arteries
- Congestive heart failure
- Left ventricular ejection fraction <35%
- Previous renal artery stenting or angioplasty
- Type 1 diabetes mellitus
Sites / Locations
- Federal Center of Cardiovascular surgery
- Regional Hospital
- Federal Center of Prophylactic Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Group 1 (RDN guided by HFS)
Group 2 (RDN as standard procedure)
Renal arteries were assessed for suitability of ablation by renal angiography. The real-time 3-dimensional aorta-renal artery maps were reconstructed with the use of navigation system and ablation catheter via femoral artery access. After that high-frequency stimulation (HFS) was used before the initial and after each radiofrequency (RF) delivery within the renal artery. RDN was considered to have been achieved when the sudden increase of blood pressure (> 15 mm Hg from invasive arterial monitoring) was eliminated in response to HFS. RF ablations of 8-12 watts (impedance drop >10%) were applied discretely from the first distal main renal artery bifurcation all the way back to the ostium. The duration of each RF delivery was 60-120 sec, and up to 6 lesions (separated by > 5 mm) were performed both longitudinally and rotationally within each renal artery.
Renal arteries were assessed for suitability of ablation by renal angiography. The real-time 3-dimensional aorta-renal artery maps were reconstructed with the use of navigation system and ablation catheter via femoral artery access. RF ablations of 8-12 watts (impedance drop >10%) were applied discretely from the first distal main renal artery bifurcation all the way back to the ostium. The duration of each RF delivery was 60-120 sec, and up to 6 lesions (separated by > 5 mm) were performed both longitudinally and rotationally within each renal artery. High-frequency stimulation (HFS) was performed before and after RDN to just to verify the response of BP