Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
EuroIntervention. 2013 May;9 Suppl R:R110-6. doi: 10.4244/EIJV9SRA19.
The autonomic nervous system (ANS) has a pivotal role in the pathogenesis and maintenance of atrial and ventricular arrhythmias. Catheter-based renal denervation (RDN) is associated with a reduction of central sympathetic activity, muscle sympathetic nerve activity, and blood pressure in resistant hypertension. As renal afferent nerves are regulators of central sympathetic tone, RDN opens the possibility to modulate sympathetic activity, but without affecting peripheral chemoreceptors and mechanoreceptors in the heart and other organs. RDN was shown to reduce heart rate in humans and to reduce inducibility of atrial fibrillation (AF) as well as ventricular rate during AF in experimental studies. First evidence indicates that pulmonary vein isolation in combination with RDN increases the rate of AF freedom in patients with resistant hypertension. Furthermore, RDN may have a beneficial impact on ventricular arrhythmia, in particular in patients with coronary artery disease or heart failure.
自主神经系统（ANS）在心房和室性心律失常的发病机制和维持中起着关键作用。基于导管的肾脏去神经（RDN）与中枢交感活性、肌肉交感神经活性和抗高血压药物抵抗患者的血压降低有关。由于肾传入神经是中枢交感神经紧张的调节剂，RDN 为调节交感活性提供了可能，但不会影响心脏和其他器官中的外周化学感受器和机械感受器。研究表明，RDN 可降低人类的心率，并降低实验研究中心房颤动（AF）的易感性以及 AF 期间的心室率。初步证据表明，在抗高血压药物抵抗患者中，肺静脉隔离与 RDN 相结合可提高 AF 自由的发生率。此外，RDN 可能对室性心律失常有有益的影响，特别是在冠心病或心力衰竭患者中。
