What is the clinical evidence from this study?

Study design: RCT. Population: Refractory symptomatic atrial fibrillation and resistant hypertension (n=27). Intervention: Pulmonary vein isolation with renal artery denervation vs. Pulmonary vein isolation only. Primary outcome: Maintenance of sinus rhythm (AF-free at 12 months) (p=0.033).

What does this research mean for the field?

Concomitant renal artery denervation with pulmonary vein isolation significantly reduces blood pressure and reduces atrial fibrillation recurrence at 12 months compared with pulmonary vein isolation alone in patients with drug-resistant hypertension. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.ESTABLISHES_NEW_DIRECTION.

What question did this study set out to answer?

To evaluate whether adding renal artery denervation to pulmonary vein isolation improves rhythm control and blood pressure in patients with refractory atrial fibrillation and resistant hypertension.

September 15, 2026Journal of the American College of Cardiology

A Randomized Comparison of Pulmonary Vein Isolation With Versus Without Concomitant Renal Artery Denervation in Patients With Refractory Symptomatic Atrial Fibrillation and Resistant Hypertension

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Key result

PVI plus renal denervation cuts 12-month AF recurrence by ~56% vs PVI alone.

P=0.033
n=27

Why the study?

Renal denervation controls blood pressure in drug-resistant hypertension, but its effect on atrial fibrillation in patients undergoing pulmonary vein isolation was unknown.

Comparison

PVI with renal artery denervation vs PVI only

Design

Prospective randomized study

Follow-up

≥1 year

Authors

EPEvgeny PokushalovElectrophysiology ARAlexander RomanovUniversity of North Carolina at Chapel Hill GCG. CorbucciValeas (Italy)

Discussion

Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

JDJohn DayDirector of Heart Rhythm Services, Intermountain Medical Center

“While this was a small study consisting of only 27 patients it definitely highlights the potential of this new therapy. In this study, patients with symptomatic paroxysmal or persistent AF refractory to antiarrhythmic drugs and drug-resistant hypertension which was defined as systolic blood pressure >160 mmHg despite triple antihypertensive drug therapy were enrolled in this study. The one-year success rate was 69% in the AF ablation and renal denervation group versus just 29% in the AF ablation only group. Clearly, renal denervation dramatically improved the success rate of AF ablation in this pilot study.”

Editorial

LCLarry ChinitzDirector, Heart Rhythm Center, NYU Langone Medical Center

“Hypertension is one of the most prevalent risk factors for developing AF, but we've seen that it is also potentially the most modifiable risk factor for halting the progression of the disease. As we continue to look for ways to prevent AF recurrence and improve outcomes for patients with AF, this trial may reveal a potential new treatment path for patients.”

News Coverage

Implication

Supports adding renal denervation to PVI in resistant hypertension with AF; extends sympathetic modulation evidence from this RCT.

Key Points

To evaluate whether adding renal artery denervation to pulmonary vein isolation improves rhythm control and blood pressure in patients with refractory atrial fibrillation and resistant hypertension.
Randomized trial allocating 27 patients with symptomatic refractory atrial fibrillation and drug-resistant hypertension to pulmonary vein isolation alone (n = 13) or isolation plus renal artery denervation (n = 14).
Patients underwent catheter ablation and were evaluated across a 12-month follow-up period with repeated blood pressure tracking and continuous cardiac rhythm monitoring.
Freedom from recurrent atrial fibrillation at 12 months was significantly higher in the pulmonary vein isolation plus renal denervation group than in the isolation-alone group (69% vs 29%, p = 0.033).
Concomitant renal artery denervation produced substantial reductions in both systolic and diastolic blood pressure, whereas blood pressure showed no significant improvement in the isolation-only group.

Study Design

Type

RCT (n=27)

Randomization

randomized

PICO

Population

27 patients with symptomatic paroxysmal or persistent AF refractory to ≥2 antiarrhythmic drugs and drug-resistant hypertension, followed for ≥1 year.

Intervention / Comparator

Pulmonary vein isolation with renal artery denervation vs Pulmonary vein isolation only

Primary Outcome

Maintenance of sinus rhythm (AF-free at 12 months), p=0.033

Main Result

Absolute Event Rate: 69% vs 29%

p-value: p=0.033

Cite This Study

Pokushalov et al. (2012) conducted an RCT in Refractory symptomatic atrial fibrillation and resistant hypertension (n=27). Pulmonary vein isolation with renal artery denervation vs. Pulmonary vein isolation only was evaluated on Maintenance of sinus rhythm (AF-free at 12 months) (p=0.033). Pulmonary vein isolation combined with renal artery denervation significantly increased the proportion of patients remaining AF-free at 12 months compared to PVI alone (69% vs 29%, p=0.033).

synapsesocial.com/papers/6aa96135958fda4bdc2b1f9b https://doi.org/10.1016/j.jacc.2012.05.036

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September 15, 2026Journal of the American College of Cardiology

A Randomized Comparison of Pulmonary Vein Isolation With Versus Without Concomitant Renal Artery Denervation in Patients With Refractory Symptomatic Atrial Fibrillation and Resistant Hypertension

View Full Paper

Ask AI

Bookmark

Key result

PVI plus renal denervation cuts 12-month AF recurrence by ~56% vs PVI alone.

P=0.033
n=27

Why the study?

Renal denervation controls blood pressure in drug-resistant hypertension, but its effect on atrial fibrillation in patients undergoing pulmonary vein isolation was unknown.

Comparison

PVI with renal artery denervation vs PVI only

Design

Prospective randomized study

Follow-up

≥1 year

Authors

EPEvgeny PokushalovElectrophysiology ARAlexander RomanovUniversity of North Carolina at Chapel Hill GCG. CorbucciValeas (Italy)

Discussion

Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

JDJohn DayDirector of Heart Rhythm Services, Intermountain Medical Center

“While this was a small study consisting of only 27 patients it definitely highlights the potential of this new therapy. In this study, patients with symptomatic paroxysmal or persistent AF refractory to antiarrhythmic drugs and drug-resistant hypertension which was defined as systolic blood pressure >160 mmHg despite triple antihypertensive drug therapy were enrolled in this study. The one-year success rate was 69% in the AF ablation and renal denervation group versus just 29% in the AF ablation only group. Clearly, renal denervation dramatically improved the success rate of AF ablation in this pilot study.”

Editorial

LCLarry ChinitzDirector, Heart Rhythm Center, NYU Langone Medical Center

“Hypertension is one of the most prevalent risk factors for developing AF, but we've seen that it is also potentially the most modifiable risk factor for halting the progression of the disease. As we continue to look for ways to prevent AF recurrence and improve outcomes for patients with AF, this trial may reveal a potential new treatment path for patients.”

News Coverage

Implication

Supports adding renal denervation to PVI in resistant hypertension with AF; extends sympathetic modulation evidence from this RCT.

Key Points

To evaluate whether adding renal artery denervation to pulmonary vein isolation improves rhythm control and blood pressure in patients with refractory atrial fibrillation and resistant hypertension.
Randomized trial allocating 27 patients with symptomatic refractory atrial fibrillation and drug-resistant hypertension to pulmonary vein isolation alone (n = 13) or isolation plus renal artery denervation (n = 14).
Patients underwent catheter ablation and were evaluated across a 12-month follow-up period with repeated blood pressure tracking and continuous cardiac rhythm monitoring.
Freedom from recurrent atrial fibrillation at 12 months was significantly higher in the pulmonary vein isolation plus renal denervation group than in the isolation-alone group (69% vs 29%, p = 0.033).
Concomitant renal artery denervation produced substantial reductions in both systolic and diastolic blood pressure, whereas blood pressure showed no significant improvement in the isolation-only group.

Study Design

Type

RCT (n=27)

Randomization

randomized

PICO

Population

27 patients with symptomatic paroxysmal or persistent AF refractory to ≥2 antiarrhythmic drugs and drug-resistant hypertension, followed for ≥1 year.

Intervention / Comparator

Pulmonary vein isolation with renal artery denervation vs Pulmonary vein isolation only

Primary Outcome

Maintenance of sinus rhythm (AF-free at 12 months), p=0.033

Main Result

Absolute Event Rate: 69% vs 29%

p-value: p=0.033

Cite This Study

synapsesocial.com/papers/6aa96135958fda4bdc2b1f9b https://doi.org/10.1016/j.jacc.2012.05.036

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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