Where Are We Going?
At this time, the technology leaders in renal denervation seem committed to exploring further the efficacy of the technology in renal denervation. Medtronic, St. Jude and Boston Scientific have indicated that they are continuing with plans to study renal denervation using radiofrequency energy in human hypertension. The use of renal denervation in a number of comorbidities other than hypertension is also continuing at this time (see Table 1 or visit http://www.clinicaltrials.gov and enter the search term 'renal denervation'). Ultrasound approaches to renal denervation are also continuing. Medtronic remains committed to the field in its support of the Global Symplicity registry which will track long-term outcomes in 5000 people who have undergone renal denervation.
The use of renal denervation for patients with less severe degrees of blood pressure elevation (for instance, office values of 140–159 mmHg though taking multiple antihypertensive medications) was discontinued on the basis of the results presented at the American College of Cardiology 2014 Conference for HTN3, and also on the basis of the Global Symplicity registry, in which office systolic reductions in this population were found to be small. Consistent with this, Medtronic announced in March 2014 that they were discontinuing further enrollment into the Symplicity HTN4 trial which had as its entrance systolic blood pressure a value of 140–159 mmHg in the office.