Renal Denervation and pUlmonary Vein isolAtion With cryoabLation on Patients With Atrial Fibrillation and hypErtension

This is an interventional treatment trial for Paroxysmal Atrial Fibrillation focused on measuring Renal artery cryoablation, Pulmonary vein cryoablation, One-stop cardio-renal combined cryoablation therapy Read More

Inclusion Criteria:

1. Age ≥18 years old, and <75 years old, gender is not limited;
2. Hypertensive patients with symptomatic paroxysmal atrial fibrillation to be treated by catheter ablation with substandard blood pressure. SBP ≥ 150 mmHg or DBP ≥ 90 mmHg in patients taking at least one antihypertensive drug;
3. Agree to participate and sign the informed consent.

Exclusion Criteria:

1. Cannot accept catheter ablation (such as thrombus in left atrium/left atrial appendage, recent myocardial infarction, stroke, etc.);
2. Patients with obvious bleeding tendency or unable to accept postoperative anticoagulation;
3. The anteroposterior diameter of left atrium indicated by echocardiography was ≥50mm;
4. A history of left atrial surgery or left atrial interventional therapy (including cryo-ablation, radiofrequency ablation, left atrial appendage occlusion, etc.);
5. NYHA grade IV congestive heart failure or LVEF <30%;
6. patients with valvular atrial fibrillation and secondary atrial fibrillation (such as uncontrolled hyperthyroidism, acute alcoholism, atrial fibrillation after cardiac surgery, etc.);
7. Patients with typical atrial fluttering or other supraventricular tachycardia (duration greater than 30s) confirmed by preoperative electrocardiogram or dynamic electrocardiogram;
8. Severe organic heart disease, including moderate to severe mitral insufficiency or stenosis, previous myocardial infarction, hypertrophic cardiomyopathy, etc.;
9. Patients with secondary hypertension;
10. Uncontrollable pulmonary hypertension;
11. Patients with glomerular filtration rate (EGFR) < 45ml/min/1.73m2 or patients with chronic kidney disease, nephrotic syndrome, polycystic kidney disease and other renal diseases were estimated according to MDRD calculation method;

12. Renal artery imaging (renal artery CTA) exclusion criteria:

    1. inability to access the renal vascular system;
    2. Diameter of renal aorta less than 4 mm or length less than 20 mm;
    3. Hemodynamic or anatomical renal artery abnormalities or stenosis;
    4. A history of previous renal artery interventions, including balloon angioplasty or stenting;
    5. There are multiple unilateral renal aortas leading to the kidney;
13. Participated in other clinical studies and not yet enrolled in the group;
14. Women who are pregnant, lactating or preparing to become pregnant;
15. Life expectancy less than 1 year;
16. Other conditions that are not suitable for inclusion in this study as assessed by the researcher, such as mental disorders or psychological disorders;
17. A history of acute coronary events or percutaneous coronary stent intervention, a history of stroke or transient ischemic attack, and extensive atherosclerosis with intravascular thrombosis within the last 6 months;
18. Patients with ICD implantation history or CRT treatment history.