Tag Archives: renal denervation

What is the future of cardiovascular health? NHS Medical Director Professor Sir Stephen Powis opened the conference by outlining the growing need to provide high quality cardiovascular care. With a quarter of deaths in England attributable to cardiovascular disease and a wider cost to the economy of £15.8 billion per year,1 there is an urgent need for innovative care pathways and new technologies. He showcased virtual wards as one example of innovation, with over 100,000 patients having been managed remotely in 2022.2 In Liverpool, a Telehealth team has successfully utilised a medical monitoring app to manage patients at home, leading to a 1

Coronary intervention – Trials As the first ever blinded, sham-controlled, percutaneous coronary intervention (PCI) trial, demonstrating a non-statistically significant increase in exercise time at six weeks from PCI over optimal medical therapy (OMT), to say the publication of ORBITA (Percutaneous Coronary Intervention in Stable Angina) last year caused a stir would be quite the understatement. Regardless of your interpretation of the data,1 or ensuing hyperbole,2 unanswered questions certainly remained. Presentation of the previously blinded, invasive physiology data in the opening late-breaking clinical trials session here was therefore

HEAT-PPCI: heparin outperforms bivalirudin in primary PCI The major talking point of this year’s American College of Cardiology meeting was without doubt the aptly named HEAT-PPCI trial which generated more heat than has been seen at such conferences for quite some time. The trial acronym stands for How Effective Are Antithrombotic Therapies in Primary PCI (percutaneous coronary intervention), and the study – conducted in the UK under the leadership of Dr Rod Stables (Liverpool Heart and Chest Hospital) – compared unfractionated heparin with bivalirudin (Angiomax®, the Medicines Company) in patients with ST-elevation myoca

Dr Melvin D Lobo (William Harvey Heart Centre, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London) The past three years has serendipitously seen the emergence of a novel class of device therapies for hypertension with renal sympathetic denervation (RSD) and baroreflex activation therapy currently leading the way. The intense interest in RSD is reflected in the fact that there are now more than 60 device manufacturers competing in this environment to produce technologies that cause renal nerve destruction through a variety of energy modalities based upon the fact that renal nerve

The statement, published online in the European Heart Journal (25th April 2013, doi: 10.1093/eurheartj/eht154), is written by a committee led by Dr Felix Mahfoud (Saarland University, Saar, Germany). They state that the data support the concept that radiofrequency ablation of the renal nerves reduces blood pressure and improves blood-pressure control in these difficult-to-treat patients, with results now extending to 36 months. The statement also reviews the appropriate screening measures necessary to select patients eligible for renal denervation. These are: office-based blood pressure >160 mmHg (>150 mmHg in patients with type 2 diab

WOEST: aspirin not required for stent patients on oral anticoagulants  A strategy of using clopidogrel as a single antiplatelet drug for patients receiving a drug-eluting stent who are also taking an oral anticoagulant appears safe and can reduce bleeding, the results of the WOEST study suggest. How to treat patients on anticoagulation when they receive a stent is fraught with difficulty as giving the normal dual antiplatelet therapy with aspirin and clopidogrel means they will be taking three anti-clotting agents which could increase bleeding complications to a dangerous level. But no randomised clinical trials have ever investigated whethe

Highlights of the American Heart Association 2010 meeting held in November 2010, in Chicago, USA, included a breakthrough for the treatment of resistant hypertension, and another oral anticoagulant that could be used instead of warfarin in atrial fibrillation patients, without the need for monitoring. RAFT: CRT reduces deaths and hospitalisations in mild heart failure Adding cardiac-resynchronisation therapy (CRT) to implantable cardioverter defibrillator (ICD) and medication, led to a reduction in deaths and heart failure hospitalistions among patients with mild-to-moderate symptoms of heart failure in the RAFT (Resynchronisation-Defibrilla

An initial proof of principle study was reported in The Lancet (Krum H et al. Lancet 2009;373:1275–81) by Dr Henry Krum (Monash University, Melbourne, Australia) and co-investigators who, using the newly developed Symplicity® catheter system, performed RDN in 45 patients with resistant hypertension (systolic blood pressure [SBP] ≥160 mmHg on three antihypertensive agents); the procedure lasting a median of 38 minutes. The primary end points were office blood pressure (BP) and safety data at one, three, six, nine and 12 months, and patient’s renal angiography and magnetic resonance angiography during follow-up. BP was significantly redu