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10.18632/oncotarget.16278

http://scihub22266oqcxt.onion/10.18632/oncotarget.16278
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C5513716!5513716 !28415795
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suck abstract from ncbi


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pmid28415795
      Oncotarget 2017 ; 8 (23 ): 37296-37307
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  • Renal sympathetic denervation guided by renal nerve stimulation to treat ventricular arrhythmia in CKD patients with ICD #MMPMID28415795
  • Kiuchi MG ; Chen S ; Paz LMR ; Pürerfellner H
  • Oncotarget 2017[Jun]; 8 (23 ): 37296-37307 PMID28415795 show ga
  • Chronic kidney disease (CKD) patients on stage 4 present greater risk rates for malignant ventricular arrhythmia events. This study examined patients with CKD in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, "Anti-tachycardia Therapy Pacing" (ATP) and shock events during the 18 months of follow-up and compare the incidence and severity of these at different stages of CKD, mainly in patients with CKD stage 4 underwent renal sympathetic denervation (RSD) guided by renal nerve stimulation (RNS). One hundred and fifteen patients were evaluated once every three months till 18 months of follow-up. The arrhythmic events were assessed at each follow-up visit. Comparing the groups, we can see the number of ATP and shock events recorded by ICD during 18 months of follow-up, and differences in the number of therapeutic events between the various stages of CKD. The hazard ratio (HR), 95% confidence interval (CI) and P value for ATP and shock events between all the CKD stages were evaluated by the log-rank/Mantel-Haenszel test. At the 18th month of follow-up, 75% of patients with CKD stage 4 received ATP, and 70% were treated with shock while only 20% of the subjects with CKD stage 4 that were submitted to RSD received ATP and 20% were treated with shock, P<0.0001 and P=0.0002, respectively. In our study, a decline occurred in the incidence of arrhythmias, and therefore, appropriate ICD therapies in advanced stages of CKD, reducing the risk rates for these events in patients with CKD on stage 4 after RSD guided by RNS in comparison to the other CKD stages. Our results suggest that RSD can control the higher incidence of malignant arrhythmias in advanced CKD stages.
  • |*Sympathectomy [MESH]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Arrhythmias, Cardiac/complications/*surgery [MESH]
  • |Cohort Studies [MESH]
  • |Defibrillators, Implantable/statistics & numerical data [MESH]
  • |Electric Countershock [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Kidney/innervation/*surgery [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Renal Insufficiency, Chronic/complications/*surgery [MESH]


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