Image: A new mapping catheter helps plan renal denervation (Photo courtesy of Rainbow Medical).
A unique nerve mapping technology provides more effective renal denervation (RDN) treatment for resistant hypertension.
The Pythagoras Medical (Hertzliya, Israel) ConfidenHT system is based on a multi-electrode, non-occluding flexible over-the-wire catheter with an expendable multi electrode design compatible with an 8 French guiding catheter and 0.014" guide wire, suitable for a wide range of renal artery diameters. The electrical stimulation of sympathetic fibers in the renal arteries elicits a reciprocal sympathetic response, which in turn induces a transient change in several physiological measurable parameters, such as heart rate and blood pressure, and allows real time intra-arterial blood pressure monitoring.
The mapping catheter features multi-channel stimulation capabilities and an algorithm that uses the multi-factorial physiological responses to create a map of hotspots for ablation. Stimulation outcomes are displayed on the proprietary 15" touch screen ConfidenHT mapping console, which also provides visualization of the artery's mapping results and hot-spot locations. The technology also reduces the risk factor associated with unnecessary ablation, as it also verifies ablation effectiveness and identifies non-responder patients.
“This renal fiber stimulation project is, without a doubt, a very promising step in our endeavor to locate the ‘sweet-spots’ where renal ablation produces will achieve the best results,” said Professor Konstantinos Tsioufis, MD, PhD, of Hippocratio Hospital (Athens, Greece), president of the European Society of Hypertension (ESH). “Our preliminary experience seems to bring us closer to the goal of ‘unblinding’ the renal denervation procedure.”
RDN is a minimally invasive, radiofrequency (RF) or ultrasound ablation procedure aimed at treating resistant hypertension. Nerves in the wall of the renal artery are ablated, which causes reduction of sympathetic afferent and efferent activity to the kidney, decreasing blood pressure. While early data from international clinical trials demonstrated large blood pressure reductions in patients with treatment-resistant hypertension, a 2014 a prospective, sham-controlled clinical trial failed to confirm this finding.