Efficacy and safety of renal denervation in patients with refractory ventricular electrical storm.

BACKGROUND: Ventricular electrical storm (ES) is a malignant arrhythmia that seriously threatens the patients' life. Renal denervation (RDN) has been described as a treatment modality for refractory ventricular arrhythmias. This study aims to explore the potential role in patients with ablation-refractory ES. METHODS: This single-center retrospective cohort study included patients with refractory ES who underwent RDN between 2023 and 2024 with a follow-up period for 2-6 months. Implantable cardioverter defibrillator (ICD) programming results and intraoperative parameters were collected. Patients' clinical examination results were also compiled. RESULTS: The study involved 10 patients with a mean age of 57.9 ± 7.4 years, including 4 (40%) ischemic cardiomyopathy, 6 (60%) dilated cardiomyopathy and 6 (60%) hypertension. ICD therapies showed a decreasing trend after multimodal therapy including RDN [pre-RDN 22 [9.3, 41], post-RDN 2.5 [0, 26.3]]. ICD shock therapies exhibited a similar descending tendency [pre-RDN 8.5 [1, 12.8] and post-RDN 0.5 [0, 3.5]]. Echocardiography and plasma results remained unchanged before and after surgery, including ejection fraction, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and creatinine concentration. CONCLUSION: Multimodal therapy including RDN may has the potential to contribute to decrease ICD therapies for patients with ES. Larger sample investigations may further demonstrate the efficacy and safety of RDN.