COMPARATIVE EFFECTIVENESS OF RADIOFREQUENCY MONOELECTRODE AND MULTIELECTRODE SYSTEMS FOR RENAL ARTERY DENERVATION IN RESISTANT ARTERIAL HYPERTENSION: RESULTS OF A 6-MONTH FOLLOW-UP

Galimov Rustam Ramisovich, Molchanov Andrey Nikolaevich, Gorgun Ales Grigorievich, Pavlov Prokhor Igorevich

Objective. To compare the efficacy and safety of three different systems for radiofrequency renal denervation in patients with resistant hypertension. Materials and methods. The study included 148 patients with true resistant hypertension, divided into 4 groups: Group A (n=34) – renal denervation with a mono-electrode monopolar system; Group B (n=37) – renal denervation with a multi-electrode bipolar system; Group C (n=39) – renal denervation with a multi-electrode monopolar system; and Group D (n=38) – a control group (medication only). The dynamics of office blood pressure and 24-hour ambulatory blood pressure monitoring parameters were assessed after 6 months. Results. At the 6-month follow-up, statistically significant differences in blood pressure reduction were found between the groups. The greatest reduction in office systolic/diastolic blood pressure was recorded in Group C (multi-electrode monopolar system): -10.8/-5.9 mm Hg, p<0.001. According to 24-hour ambulatory blood pressure monitoring, Group C also showed the maximum reduction in 24-hour systolic BP (-8.4 mm Hg, p<0.001) and nighttime systolic BP (-7.8 mm Hg, p<0.001). Group B (multi-electrode bipolar system) showed intermediate results, while Group A (mono-electrode monopolar system) showed the least, albeit statistically significant, reduction. No significant changes were detected in the control group. The safety profile was favorable in all groups, with no significant differences in renal function dynamics. Conclusion. Radiofrequency renal denervation is an effective and safe method for treating resistant hypertension. The multi-electrode system demonstrated a statistically significant greater antihypertensive effect after 6 months compared to the mono-electrode system.

Keywords:renal denervation, resistant hypertension, radiofrequency ablation, ambulatory blood pressure monitoring, renal arteries, sympathetic nervous system.