Atrial autonomic innervation: a target for interventional antiarrhythmic therapy?
Atrial fibrillation is the most common arrhythmia and is associated with significant morbidity and mortality. The autonomic nervous system contributes to the creation of atrial fibrillation substrates. Atrial electrophysiology is influenced differently by sympathetic and parasympathetic activation. Several strategies are available to modulate the complex interaction between the autonomic nervous system and the heart. However, different approaches target the problem differently making the prediction of arrhythmogenic and/or antiarrhythmic effects difficult. We discuss the role of the autonomic nervous system on the development of a substrate for atrial fibrillation and explore the potential antiarrhythmic and/or arrhythmogenic effect of modulation of the autonomic nervous system by renal sympathetic denervation, ganglionated plexi ablation, ganglion stellatum ablation, high thoracic epidural anesthesia, low-level vagal nerve stimulation, and baroreflex stimulation.
['Linz|Dominik|D|', 'Ukena|Christian|C|', 'Mahfoud|Felix|F|', 'Neuberger|Hans-Ruprecht|HR|', 'Böhm|Michael|M|']
D000889:Anti-Arrhythmia Agents D001341:Autonomic Nervous System D017115:Catheter Ablation D004562:Electrocardiography D006325:Heart Atria D006801:Humans D013562:Sympathectomy
atrial fibrillation renal sympathetic denervation ganglionated plexi baroreflex stimulation AERP AF BRS CB GP M2R OSA PVI RDN atrial effective refractory period autonomic modulation baroreceptor stimulation carotid bodies cholinergic muscarinergic receptors obstructive sleep apnea pulmonary vein isolation renal denervation