Evidence map›Paper›PMID 40204910›Full record

SynthesisHerz2025

Renal denervation plus cardiac ablation vs. cardiac ablation alone for patients with atrial fibrillation and uncontrolled arterial hypertension : A systematic review and updated meta-analysis of randomized controlled trials.

Ocílio Ribeiro Gonçalves, Altair Pereira de Melo Neto, Maria Antonia Oliveira Machado Pereira, Victor Arthur Ohannesian, Matheus Augusto Nepomuceno Fernandes, Clara Rocha Dantas, Maria Tereza Camarotti, João Victor Araújo de Oliveira, Gustavo José Silva Sanchez, Carlos Eduardo Batista de Lima and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Herz, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ocílio Ribeiro GonçalvesDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Bairro Ininga, Teresina-PI, Brazil. ocilio41@gmail.com.ORCID http://orcid.org/0009-0008-6103-8420
Altair Pereira de Melo NetoDepartment of Medicine, Federal University of Roraima, Boa Vista, Brazil.
Maria Antonia Oliveira Machado PereiraDepartment of Medicine, State University of Piauí, Teresina, Brazil.
Victor Arthur OhannesianDepartment of Medicine, Albert Einstein Israeli Faculty of Health Sciences (FICSAE), São Paulo, Brazil.
Matheus Augusto Nepomuceno FernandesDepartment of Medicine, Anhembi Morumbi University, São Paulo, Brazil.
Clara Rocha DantasDepartment of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Maria Tereza CamarottiDepartment of Medicine, Faculdade Pernambucana de Saúde, Recife, Brazil.
João Victor Araújo de OliveiraDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Bairro Ininga, Teresina-PI, Brazil.
Gustavo José Silva SanchezDepartment of Medicine, Centro Universitário São Camilo, São Paulo, Brazil.
Carlos Eduardo Batista de LimaDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Bairro Ininga, Teresina-PI, Brazil.
Avelar Alves da SilvaDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Bairro Ininga, Teresina-PI, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is a complex arrhythmia often worsened by hypertension (HTN). Pharmacological treatments frequently underperform, and the best approach, particularly combining renal denervation (RDN) with cardiac ablation (CA), remains unclear.

objectiveWe conducted an updated meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of RDN combined with CA versus CA alone in patients with AF and uncontrolled HTN.

methodsWe performed a systematic review and meta-analysis of RCTs retrieved from PubMed, Embase, and the Cochrane Library up to July 2024. Primary outcomes included AF recurrence, periprocedural complications, blood pressure changes, and estimated glomerular filtration rate (eGFR). Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random-effects model.

resultsEight RCTs were included, involving 689 patients (37% female). Of these, 355 underwent RDN + CA, and 334 underwent CA alone, with a mean follow-up of at least 12 months. The RDN + CA group exhibited a significant reduction in AF recurrence (RR: 0.77; 95% CI: 0.61-0.97). There were no significant differences in periprocedural complications (RR: 1.06; 95% CI: 0.60-1.89), systolic blood pressure (MD: -6.79; 95% CI: -14.71-1.14), diastolic blood pressure (MD: -2.47; 95% CI: -8.13-3.20), or eGFR (MD: 1.14; 95% CI: -11.95-14.23).

conclusionOur findings show that RDN combined with CA significantly reduces AF recurrence compared to CA alone, presenting a promising approach for patients with resistant HTN and AF.

Indexed as

Atrial FibrillationCatheter AblationDenervationHypertensionKidneyCombined Modality TherapyFemaleHumansMaleRandomized Controlled Trials as TopicTreatment OutcomeAtrial fibrillationCardiac ablationHypertensionMeta-analysisRenal denervation

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.