Ep. 26 Renal Denervation: Innovations in Hypertension Management with Dr. Eric Secemsky

John Doe is a 45 year-old male with a past medical history of hypertension, on high doses of amlodipine, metoprolol and lisinopril presenting to his cardiologist with a blood pressure of 165/86. He asks, “If the medications are not controlling my blood pressure, what are my options?” In this episode of the BackTable Cardiology Podcast, Dr. Sameh Sayfo sits down with Dr. Eric Secemsky, an internationally recognized interventional cardiologist and vascular medicine specialist to discuss renal denervation, a minimally invasive procedure that lowers blood pressure by disrupting overactive renal sympathetic nerves. --- SYNPOSIS From its proof of concept to the clinical trials that have shaped the current landscape, Drs. Sayfo and Secemsky dive into the intricacies of renal denervation. They explore the technical aspects of catheter-based denervation devices like Medtronic's Spyral catheter and Recor's Paradise device, discussing their procedures, safety features, and troubleshooting tips. The conversation also covers the significance of building advanced hypertension centers, the latest in renal denervation innovations, and the creation of a national registry to track procedural outcomes and enhance patient care. --- TIMESTAMPS 00:00 - Introduction02:52 - Guidelines Update: Why Renal Denervation Earned a Class 2B Recommendation07:31 - Clinical Trials: What Went Wrong, What We Learned, and How Devices Improved15:08 - Medtronic Symplicity Spyral22:17 - ReCor Paradise27:30 - Covering the Main Renal Artery: Anatomic Variants and Proximal Treatment Strategy33:15 - Beyond Kidneys: Multi-Organ Denervation and Metabolic Effects40:27 - Why Institutions Should Build Hypertension Centers --- RESOURCES Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Eric Secemsky’s Provider Profilehttps://findadoc.bidmc.org/details/3519 A Controlled Trial of Renal Denervation for Resistant Hypertensionhttps://www.nejm.org/doi/full/10.1056/NEJMoa1402670 Medtronic Symplicity Spyral™ Renal Denervation Systemhttps://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/symplicity-spyral-renal-denervation-system.html SPYRAL GEMINI Pilot Studyhttps://clinicaltrials.gov/study/NCT06907147 Ablation of Arteries for the Treatment of Type 2 Diabetes Mellitus and Its Comorbidities (NECTAR IV) Trial https://clinicaltrials.gov/study/NCT05369065