JSCAI Conversations in Interventional Cardiology: A Blueprint for Building a Renal Denervation Program-A Blueprint for Building a Renal Denervation Program

Video Transcription

Video Summary

The panel reviews a J-SCHI manuscript outlining how to build a renal denervation (RDN) program for uncontrolled/resistant hypertension. Dr. Tayyab Shah explains RDN’s mechanism (ablating renal sympathetic nerves) and sham-controlled trial outcomes: average systolic BP reduction ~5–10 mmHg, with variable response (about one-third minimal benefit, one-third moderate, one-third larger 10–20 mmHg drops). The “blueprint” centers on four elements: creating a CMS-required multidisciplinary hypertension team, designing patient workflow (secondary hypertension workup, medication optimization, eligibility imaging), securing equipment and operator training, and financial planning amid evolving reimbursement (CMS coverage with evidence development; Category III CPT moving toward Category I). Penn experts discuss positioning RDN after guideline-based multidrug therapy or medication intolerance, practical clinic processes to evaluate and prepare patients within months, and documentation strategies to aid insurance authorization. Operator learning is described as straightforward for coronary/structural-trained interventionalists with proctorship requirements.

Keywords

renal denervation (RDN) program

resistant/uncontrolled hypertension

renal sympathetic nerve ablation mechanism

sham-controlled trial blood pressure reduction

CMS coverage with evidence development & CPT reimbursement

multidisciplinary hypertension team and patient workflow