Adjunctive Renal Denervation in the Treatment of Atrial Fibrillation

Inclusion Criteria:

• Inclusion Criteria

• Age ≥ 18 years of age

• History of AF (paroxysmal or persistent) and planned for a guideline-supported catheter ablation procedure

• History of significant hypertension (defined as SBP ≥160 mm Hg and/or DBP ≥100 mmHg) and receiving treatment with at least one anti-hypertensive medication OR Clinical History of hypertension and receiving treatment with at least two anti-hypertensive medications (specifically for blood pressure reduction).

• Renal vasculature is accessible as determined by intra-procedural renal angiography.

• Ability to understand the requirements of the study

• Willingness to adhere to study restrictions, comply with all post-procedural follow-up requirements and to sign informed consent

Exclusion Criteria

• Inability to undergo AF catheter ablation (e.g., presence of a left atrial thrombus, contraindication to all anticoagulation)

• Prior left atrial ablation for an atrial arrhythmia (before this index procedure)

• Patients with NYHA class IV congestive heart failure

• Individual has known secondary hypertension

• Individual has renal artery anatomy that is ineligible for treatment including:

1. Inability to access renal vasculature

2. Main renal arteries < 3 mm in diameter or < 20 mm in length.

3. Hemodynamically or anatomically significant renal artery abnormality or stenosis in either renal artery which, in the eyes of the operator, would interfere with safe cannulation of the renal artery or meets standards for surgical repair or interventional dilation.

4. A history of prior renal artery intervention including balloon angioplasty or stenting that precludes a possibility of ablation treatment.

• Individual has an estimated glomerular filtration rate (eGFR) of less than 45mL/min/1.73m2, using the MDRD calculation.

• Individual has a single functioning kidney (either congenitally or iatrogenically).

• Individual is pregnant or nursing.

• Life expectancy <1 year for any medical condition