Renal Denervation in Patients With Recurrent Atrial Fibrillation After Successful Pulmonary Vein Isolation (REDE-AF)

Inclusion Criteria: Informed Consent signed by the subject ≥ 18 years of age Recurrent, paroxysmal atrial fibrillation post repeat (≥2) pulmonary vein isolation Documentation of atrial fibrillation ≥3 months after the last atrial fibrillation ablation procedure by a 12-lead ECG or on a rhythm strip of ≥30 seconds duration Either an office systolic blood pressure ≥130 mmHg at the screening visit or antihypertensive drug therapy Exclusion Criteria: Persistent or permanent atrial fibrillation post pulmonary vein isolation Left ventricular ejection fraction <40% Severe aortic or mitral valve stenosis Treatment with amiodaron within the last 3 months Mandatory treatment with class I or III antiarrhythmic drugs History of reflex syncope, syncope due to orthostatic hypotension or unclear syncope in the past 3 years. History of orthostatic hypotension Abnormal blood pressure fall during active standing, defined as a progressive and sustained fall in systolic blood pressure from baseline value ≥20 mmHg or diastolic blood pressure ≥10mmHg, or a decrease in systolic blood pressure to <90 mmHg. Prior renal denervation Renal artery stent or prior renal angioplasty Polycystic kidney disease, unilateral kidney, or history of renal transplant Estimated glomerular filtration rate (eGFR) < 50mL/min, using the CKD-EPI creatinine equation (Chronic Kidney Disease Epidemiology) Female of childbearing potential (age <50 years and last menstruation within the last 12 months), who did not undergo tubal ligation, ovariectomy or hysterectomy. Life expectancy <1 year Enrolment in interventional studies if the other study does not allow enrolment or if primary endpoint might be affected by study participation. Diabetes mellitus type I Aortic grafts The following exclusion criteria will apply after the run-in phase of up to 3 months duration, prospectively in patients which receive a new ICM and retrospectively in patients which already have an ICM implanted: - Episodes of atrial fibrillation on <6 days in the 3 months run-in phase.