Role of the Autonomic Nervous System in Atrial Fibrillation
Top Cited Papers
- 25 April 2014
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation Research
- Vol. 114 (9), 1500-1515
- https://doi.org/10.1161/circresaha.114.303772
Abstract
Autonomic nervous system activation can induce significant and heterogeneous changes of atrial electrophysiology and induce atrial tachyarrhythmias, including atrial tachycardia and atrial fibrillation (AF). The importance of the autonomic nervous system in atrial arrhythmogenesis is also supported by circadian variation in the incidence of symptomatic AF in humans. Methods that reduce autonomic innervation or outflow have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias, suggesting that neuromodulation may be helpful in controlling AF. In this review, we focus on the relationship between the autonomic nervous system and the pathophysiology of AF and the potential benefit and limitations of neuromodulation in the management of this arrhythmia. We conclude that autonomic nerve activity plays an important role in the initiation and maintenance of AF, and modulating autonomic nerve function may contribute to AF control. Potential therapeutic applications include ganglionated plexus ablation, renal sympathetic denervation, cervical vagal nerve stimulation, baroreflex stimulation, cutaneous stimulation, novel drug approaches, and biological therapies. Although the role of the autonomic nervous system has long been recognized, new science and new technologies promise exciting prospects for the future.Keywords
This publication has 133 references indexed in Scilit:
- Acute myocardial infarction induces bilateral stellate ganglia neural remodeling in rabbitsCardiovascular Pathology, 2012
- Sympathetic stimulation increases dispersion of repolarization in humans with myocardial infarctionAmerican Journal of Physiology-Heart and Circulatory Physiology, 2012
- Targeted nonviral gene-based inhibition of Gαi/o-mediated vagal signaling in the posterior left atrium decreases vagal-induced atrial fibrillationHeart Rhythm, 2011
- Heart Failure Decreases Nerve Activity in the Right Atrial Ganglionated PlexusJournal of Cardiovascular Electrophysiology, 2011
- Autonomic Remodeling in the Left Atrium and Pulmonary Veins in Heart FailureCirculation: Arrhythmia and Electrophysiology, 2011
- The cardiac neuronal hierarchy and susceptibility to arrhythmiasHeart Rhythm, 2011
- Patterns of baseline autonomic nerve activity and the development of pacing-induced sustained atrial fibrillationHeart Rhythm, 2011
- Genesis of Phase 3 Early Afterdepolarizations and Triggered Activity in Acquired Long-QT SyndromeCirculation: Arrhythmia and Electrophysiology, 2011
- Histopathological substrate for chronic atrial fibrillation in humansHeart Rhythm, 2009
- α-Adrenoceptor blockade modifies neurally induced atrial arrhythmiasAmerican Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2008