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Role of the Autonomic Nervous System in Modulating Cardiac Arrhythmias

Circulation research, 2014-03, Vol.114 (6), p.1004-1021 [Peer Reviewed Journal]

2014 American Heart Association, Inc. ;ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.113.302549 ;PMID: 24625726

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Title:
Role of the Autonomic Nervous System in Modulating Cardiac Arrhythmias
Author: Shen, Mark J ; Zipes, Douglas P
Subjects: Acupuncture Therapy ; Animals ; Arrhythmias, Cardiac - genetics ; Arrhythmias, Cardiac - physiopathology ; Arrhythmias, Cardiac - prevention & control ; Arrhythmias, Cardiac - therapy ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - therapy ; Autonomic Nervous System - physiopathology ; Cardiovascular Agents - therapeutic use ; Catheter Ablation ; Cryosurgery ; Death, Sudden, Cardiac ; Disease Models, Animal ; Electric Stimulation Therapy - methods ; Ganglia, Autonomic - physiopathology ; Heart Conduction System - physiopathology ; Heart Rate - physiology ; Humans ; Medulla Oblongata - physiopathology ; Models, Cardiovascular ; Models, Neurological ; Spinal Cord ; Vagus Nerve - physiopathology ; Vagus Nerve Stimulation ; Ventricular Fibrillation - physiopathology ; Ventricular Fibrillation - therapy
Is Part Of: Circulation research, 2014-03, Vol.114 (6), p.1004-1021
Description: The autonomic nervous system plays an important role in the modulation of cardiac electrophysiology and arrhythmogenesis. Decades of research has contributed to a better understanding of the anatomy and physiology of cardiac autonomic nervous system and provided evidence supporting the relationship of autonomic tone to clinically significant arrhythmias. The mechanisms by which autonomic activation is arrhythmogenic or antiarrhythmic are complex and different for specific arrhythmias. In atrial fibrillation, simultaneous sympathetic and parasympathetic activations are the most common trigger. In contrast, in ventricular fibrillation in the setting of cardiac ischemia, sympathetic activation is proarrhythmic, whereas parasympathetic activation is antiarrhythmic. In inherited arrhythmia syndromes, sympathetic stimulation precipitates ventricular tachyarrhythmias and sudden cardiac death except in Brugada and J-wave syndromes where it can prevent them. The identification of specific autonomic triggers in different arrhythmias has brought the idea of modulating autonomic activities for both preventing and treating these arrhythmias. This has been achieved by either neural ablation or stimulation. Neural modulation as a treatment for arrhythmias has been well established in certain diseases, such as long QT syndrome. However, in most other arrhythmia diseases, it is still an emerging modality and under investigation. Recent preliminary trials have yielded encouraging results. Further larger-scale clinical studies are necessary before widespread application can be recommended.
Publisher: United States: American Heart Association, Inc
Language: English
Identifier: ISSN: 0009-7330
EISSN: 1524-4571
DOI: 10.1161/CIRCRESAHA.113.302549
PMID: 24625726
Source: Geneva Foundation Free Medical Journals at publisher websites
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Role of the Autonomic Nervous System in Modulating Cardiac Arrhythmias

2014 American Heart Association, Inc. ;ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.113.302549 ;PMID: 24625726

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