Supportive Treatment of Severe Heart Failure by Renal Denervation (Heart-RND)

Because of the lack of the candidates and because of restrictions of denervation at the completion date.

The overactivity of sympathetic nervous system is worsening the hemodynamic state of heart failure patients. The present study is planned to reduce the sympathetic tone in patients with severe heart failure by renal nervous denervation.

The patient population consists of heart failure patients who are not responding properly to medication and biventricular pacing therapy. The inappropriate response to these therapies is evaluated by patient history (NYHA III-IV), echocardiography (EF < 45%), 6-minute walking test (<440m) and measurements of P-ProBNP. The patients who fulfill the inclusion criteria will undergo renal nervous denervation. The patients will be followed up with the same methods as they were recruited to the study (by patient history (NYHA III-IV), echocardiography (EF < 45%), 6-minute walking test (<440m) and measurements of P-ProBNP). The overall time of follow-up will be 24 months. The patients are randomised according to the waiting list principle in a manner to 1:1. The waiting time will be 6 months.

Renal nervous denervation is performed to the patients who do not response properly to conventional therapy. The patients are randomised according to the waiting list principle.

The heart failure patients will undergo renal nervous denervation if they have not properly responded to medication and biventricular pacing therapy.

Inclusion Criteria: NYHA III-IV ejection fraction <45 % 6-minute walking test under 440m Exclusion Criteria: Unstable hemodynamic state uncooperation