Is Renal Denervation Using Radiofrequency a Treatment Option for the Ventricular Arrhythmia Following Acute Myocardial Infarction?

摘要

Ventricular arrhythmia (VA) after myocardial infarction is the most important risk factor for sudden cardiac death. Sympathetic nerve overactivation and regional cardiac hyperinnervation plays an important role in the pathogenesis of ventricular tachyarrhythmias (VT). So, the decreased sympathetic activity may prevent and treat the VAs as a target of multiple drugs including β-blockers. The evidence for a major role of the sympathetic nervous system in triggering cardiac tachyarrhythmias provided the rationale for anti-adrenergic interventions such as left cardiac sympathetic denervation (LCSD) to treat the patients with long-QT syndrome and catecholaminergic polymorphic VTs. Similar to LCSD or percutaneous suppression of stellate ganglion, renal denervation (RDN) could reduce a body norepinephrine spillover by 42% and efferent muscle sympathetic nerve activity by 66%. Ukena et al. reported that RDN could reduce the arrhythmia burden in patients with heart failure with refractory VT. Also, Hoffmann et al. reported the effect of RDN following VT ablation in the VT patient after acute myocardial infarction (AMI).