Letter by Kuebler and Friedberg Regarding Article, “Pulmonary Artery Denervation by Determining Targeted Ablation Sites for Treatment of Pulmonary Arterial Hypertension”
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To the Editor:
We read with interest the recent case report by Fujisawa et al1 in which they describe a patient with pharmacologically poorly controlled idiopathic pulmonary arterial hypertension. The authors, therefore, performed pulmonary artery denervation at targeted radioablation sites that were identified based on autonomic responses induced by high-frequency stimulation, specifically bradycardia. Pulmonary artery denervation has previously been tested in a clinical phase II trial with promising results in that mean pulmonary arterial pressure decreased by 7 mm Hg and 6-minute walk distance increased by 94 meters.2 That notwithstanding, the actual mechanism underlying this benefit remains enigmatic.
Large pulmonary arteries are conductance vessels and as such are not the main …