Autonomic nerve activity and atrial fibrillation

Peng Sheng Chen, Alex Y. Tan

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

This review focuses on the importance of autonomic nervous system (ANS) activity in the induction of paroxysmal atrial fibrillation (PAF). Clinical studies suggest that both sympathetic and parasympathetic nervous systems are important in mediating PAF. Consistent with that hypothesis, heart rate variability analyses showed that sympathovagal imbalance is present before the onset of PAF episodes. The importance of the ANS in PAF is further supported by animal experiments and recent clinical studies showing that vagal denervation enhances the efficacy of circumferential pulmonary vein ablation in preventing AF recurrence. In vitro studies show that ANS activation facilitates early afterdepolarization and triggered activity by simultaneously prolonging the intracellular calcium (Cai) transient (sympathetic effect) and shortening the action potential duration (parasympathetic effect). By simultaneously mapping the membrane potential and Cai transient in canine pulmonary vein during sympathetic stimulation, we demonstrated that spontaneous (voltage-independent) sarcoplasmic reticulum calcium release underlies the mechanisms of focal discharges. We developed and studied canine models of PAF induced by electrical, structural, and neural remodeling. We also have developed methods for long-term continuous recording of sympathetic and vagal nerve activity in ambulatory dogs. Preliminary results show that simultaneous sympathovagal discharges precede the onset of PAF in these dogs. ANS activity and Cai transient dynamics are important in the development of PAF. These studies suggest that new methods or drugs aimed at modification of cardiac ANS activity may lead to new opportunities for AF control.

Original languageEnglish (US)
Pages (from-to)S61-S64
JournalHeart Rhythm
Volume4
Issue number3 SUPPL.
DOIs
StatePublished - Mar 1 2007

Fingerprint

Autonomic Pathways
Atrial Fibrillation
Autonomic Nervous System
Calcium
Pulmonary Veins
Canidae
Parasympathetic Nervous System
Dogs
Sympathetic Nervous System
Sarcoplasmic Reticulum
Denervation
Membrane Potentials
Action Potentials
Heart Rate
Recurrence
Pharmaceutical Preparations

Keywords

  • Afterdepolarization
  • Intracellular calcium current
  • Optical mapping
  • Triggered activity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Autonomic nerve activity and atrial fibrillation. / Chen, Peng Sheng; Tan, Alex Y.

In: Heart Rhythm, Vol. 4, No. 3 SUPPL., 01.03.2007, p. S61-S64.

Research output: Contribution to journalArticle

Chen, Peng Sheng ; Tan, Alex Y. / Autonomic nerve activity and atrial fibrillation. In: Heart Rhythm. 2007 ; Vol. 4, No. 3 SUPPL. pp. S61-S64.
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