Atrial Remodeling Following Catheter-Based Renal Denervation Occurs in a Blood Pressure– and Heart Rate–Independent Manner

Abstract Objectives This study sought to investigate left atrial (LA) remodeling in relation to blood pressure (BP) and heart rate (HR) after renal sympathetic denervation (RDN). Background In addition to reducing BP and HR in certain patients with hypertension, RDN can decrease left ventricular (LV) mass and ameliorate LV diastolic dysfunction. Methods Before and 6 months after RDN, BP, HR, LV mass, left atrial volume index (LAVI), diastolic function (echocardiography), and premature atrial contractions (PAC) (Holter electrocardiogram) were assessed in 66 patients with resistant hypertension. Results RDN reduced office BP by 21.6 ± 3.0/10.1 ± 2.0 mm Hg (p  2 (p  153 PAC/24 h) was reduced (to 68 PAC/24 h) by RDN, independently of changes in LA size. Conclusions In patients with resistant hypertension, LA volume and occurrence of PAC decreased 6 months after RDN. This decrease was independent of BP and HR at baseline or the reduction in BP and HR reached by renal denervation. These data suggest that there is a direct, partly BP-independent effect of RDN on cardiac remodeling and occurrence of premature atrial contractions.