Overview

High blood pressure is a major risk factor for atrial fibrillation (AF), an irregular heart rhythm, and heart failure with preserved ejection fraction (HFpEF), a condition in which the heart becomes stiff and cannot relax properly. Both conditions can significantly affect quality of life and frequently occur together. In individuals with high blood pressure, increased activity of the nerves surrounding the kidneys can further elevate blood pressure and contribute to strain on the heart.

Renal denervation (RDN) is a procedure designed to lower blood pressure by reducing the activity of these nerves using a thin catheter and controlled energy. RDN has been shown to lower blood pressure safely in many patients; however, the potential benefits in individuals with concurrent AF and HFpEF remain uncertain.

This pilot study will be conducted in two phases. Phase 1 will assess the safety and feasibility of accessing the renal arteries and evaluating blood pressure responses to brief electrical stimulation of the renal nerves.

Eligibility

Inclusion Criteria:

1. Age ≥18 years
2. Scheduled for EP study +/- catheter ablation
3. Adequate renal function (eGFR ≥45 mL/min/1.73m²)

Exclusion Criteria:

1. Hemodynamic instability
2. Renal artery stenosis \>50%
3. Single functioning kidney
4. Previous renal artery intervention
5. Pregnancy or nursing
6. Life expectancy \<12 months
7. Unwilling or unable to provide informed consent
8. Participation in a clinical trial that may impact the outcomes of the current study