Global SYMPLICITY Registry (GSR) DEFINE

Official title

Global SYMPLICITY Registry (GSR) Denervation Findings in Real World (DEFINE)

Overview

This is a prospective, multi-center, single-arm, non-interventional and open-label registry. The purpose of the registry is to document the long-term safety and effectiveness of renal denervation in a real world patient population with hypertension GSR DEFINE is the continuation of the Global SYMPLICITY Registry and collectively will enroll approximately 5000 patients with hypertension who undergo the renal denervation procedure, from over 300 sites worldwide. Subjects included in GSR DEFINE will be followed for a minimum of 1 year and up to 5 years post-procedure. Patients with uncontrolled hypertension will be enrolled in accordance with the inclusion criteria specified in the protocol.

Detailed description

This registry will collect data prospectively on patients that receive renal denervation and treatment will be applied according to the 'Intended Use' in the IFU. The treatment will be performed according to routine hospital practice and no additional tests are required specific to the registry. This registry will serve as a tool to collect clinical data in order to expand the knowledge base of safety, effectiveness and functionality of the Medtronic renal denervation system in a real world patient population.

The key measures collected for the patients will be inclusive of, but are not limited to, blood pressure measurements, change in medications, eGFR changes (based on the MDRD formula) and clinical data pertaining to hypertension .

The inclusion criteria for the registry includes:

* Age ≥ 18 years or minimum age as required by local regulations * The patient is an acceptable candidate for renal denervation based upon the Instructions For Use for the Medtronic renal denervation system. The procedure must be performed with an initial use, market-released Medtronic renal denervation catheter. * The patient or legal representative has been informed of the nature of the registry has consented to participate and authorized the collection and release of this medical information by signing a consent form ("Patient Informed Consent Form" or "Patient Data Release Authorization Form")

Interventions

• Device Medtronic Renal Denervation System
  The Symplicity renal denervation system is comprised of a single-use, disposable catheter and a reusable radiofrequency (RF) generator. The Symplicity renal denervation system has CE Marking for the intended use of delivering low-level radiofrequency energy through the wall of the renal artery to denervate the human kidney.

Primary outcome measures

• BP Measurements [Time frame: 6 months]

Eligibility criteria

Inclusion criteria

• Age ≥ 18 years or minimum age as required by local regulations
• The patient is an acceptable candidate for renal denervation based upon the Instructions For Use for the Medtronic renal denervation system. The procedure must be performed with an initial use, market-released Medtronic renal denervation catheter.
• The patient or legal representative has been informed of the nature of the registry has consented to participate and authorized the collection and release of this medical information by signing a consent form ("Patient Informed Consent Form" or "Patient Data Release Authorization Form")

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Case-only

Study locations

Germany · 1 center

• Universitätsklinikum des Saarlandes — Homburg

Switzerland · 1 center

• Universitätsspital Basel — Basel

Publications

• Nolde JM, Kiuchi MG, Carnagarin R, Ward NC, Wanten M, Bohm M, Mahfoud F, Schmieder RE, Narkiewicz K, Schlaich MP. Impact of centrally acting sympatholytic agents on the blood pressure response to renal denervation. J Hypertens. 2026 Apr 1;44(4):592-599. doi: 10.1097/HJH.0000000000004219. Epub 2025 Dec 10. PMID 41411629
• Mihailidou AS, Mahfoud F, Schlaich M, Schmieder R, Narkiewicz K, Ruilope L, Fahy M, Bohm M, Mancia G, Nickel L, Hettrick DA, Weil J. Sex stratified analysis of patients with resistant hypertension from the Global SYMPLICITY Registry of renal denervation. Hypertens Res. 2026 Mar;49(3):904-915. doi: 10.1038/s41440-025-02446-y. Epub 2025 Nov 20. PMID 41266871
• Schlaich MP, Mahfoud F, Bohm M, Narkiewicz K, Ruilope L, Williams B, Mancia G, Sharif F, Ribichini F, Lung TH, Shetty S, Schmieder RE. Renal Denervation in Patients With Moderate to Severe Chronic Kidney Disease. Hypertension. 2025 Dec;82(12):2252-2261. doi: 10.1161/HYPERTENSIONAHA.125.25470. Epub 2025 Oct 29. PMID 41159269
• Mahfoud F, Mancia G, Schmieder RE, Ruilope L, Narkiewicz K, Schlaich M, Williams B, Ribichini F, Weil J, Almerri K, Sharif F, Lauder L, Wanten M, Fahy M, Bohm M. Outcomes Following Radiofrequency Renal Denervation According to Antihypertensive Medications: Subgroup Analysis of the Global SYMPLICITY Registry DEFINE. Hypertension. 2023 Aug;80(8):1759-1770. doi: 10.1161/HYPERTENSIONAHA.123.21283. Epu PMID 37317866
• Mahfoud F, Mancia G, Schmieder RE, Ruilope L, Narkiewicz K, Schlaich M, Williams B, Ribichini F, Weil J, Kao HL, Rodriguez-Leor O, Noory E, Ong TK, Unterseeh T, de Araujo Goncalves P, Zirlik A, Almerri K, Sharif F, Lauder L, Wanten M, Fahy M, Bohm M. Cardiovascular Risk Reduction After Renal Denervation According to Time in Therapeutic Systolic Blood Pressure Range. J Am Coll Cardiol. 2022 Nov 15; PMID 36357087
• Mahfoud F, Mancia G, Schmieder R, Narkiewicz K, Ruilope L, Schlaich M, Whitbourn R, Zirlik A, Zeller T, Stawowy P, Cohen SA, Fahy M, Bohm M. Renal Denervation in High-Risk Patients With Hypertension. J Am Coll Cardiol. 2020 Jun 16;75(23):2879-2888. doi: 10.1016/j.jacc.2020.04.036. PMID 32527396
• Mahfoud F, Bakris G, Bhatt DL, Esler M, Ewen S, Fahy M, Kandzari D, Kario K, Mancia G, Weber M, Bohm M. Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. Eur Heart J. 2017 Jan 7;38(2):93-100. doi: 10.1093/eurheartj/ehw325. PMID 28158510
• Linz D, Mancia G, Mahfoud F, Narkiewicz K, Ruilope L, Schlaich M, Kindermann I, Schmieder RE, Ewen S, Williams B, Bohm M; Global SYMPLICITY Registry Investigators. Renal artery denervation for treatment of patients with self-reported obstructive sleep apnea and resistant hypertension: results from the Global SYMPLICITY Registry. J Hypertens. 2017 Jan;35(1):148-153. doi: 10.1097/HJH.000000000000114 PMID 27906840

Identifiers

NCT: NCT01534299 · 10031728DOC

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗