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Renal sympathetic denervation: renal nerve stimulation

PhD ceremony:Mr M.R. (Mark) de Jong
When:November 20, 2019
Supervisors:prof. dr. M. (Michiel) Rienstra, prof. dr. I.C. (Isabelle) van Gelder
Co-supervisor:dr. A. Elvan
Where:Academy building RUG
Renal sympathetic denervation: renal nerve stimulation

This thesis is a collection of research regarding high blood pressure and renal sympathetic denervation. High blood pressure is a silent killer and a major risk factor for cardiovascular disease. Treatment of an elevated blood pressure can be achieved with medication. When medication fails and patients appear to suffer from drug resistant hypertension, a renal sympathetic denervation is a possible treatment. This is a way to burn away the nerves that influence the fight and flight mechanisms in your body from the inside of the renal arteries. By downscaling the sympathetic nerve activity the kidneys receive less information to create high blood pressure. The thesis shows the results of enhancement of the regular renal denervation with a technique that uses electrical energy to find these sympathetic nerves. The technique is called renal nerve stimulation. This is a new and functional approach to renal sympathetic denervation. The research demonstrates how renal nerve stimulation can be used to improve the ablation of the nerves, prevents unnecessary ablation of other nerves and possibly to identify when the procedure is finished. The final part of the thesis describes the randomized controlled trial that is currently recruiting patients with the heart rhythm disturbance atrial fibrillation. Patients with high blood pressure and atrial fibrillation might benefit from the regular treatment, which is isolation of the pulmonary veins, by adding renal sympathetic denervation to their treatment.