How to Map Autonomic Activity

Eue Keun Choi, Mark J. Shen, Shien Fong Lin, Michael C. Fishbein, Lan S. Chen, Peng Sheng Chen

Research output: Chapter in Book/Report/Conference proceedingChapter


The heart is highly innervated by extrinsic and intrinsic cardiac autonomic nervous system. Both sympathetic and parasympathetic nervous system may contribute to the induction of cardiac arrhythmia. It is feasible to map nerve activities by directly recording from nerve structures in ambulatory animals. Most intrinsic cardiac nerve activity (ICNA) showed a close temporal relationship with extrinsic cardiac nerve activity (ECNA), whereas some ICNA activated without a temporal relationship with ECNA, suggesting that ICNA may be independently arrhythmogenic. Sympathovagal co-activation is the most common ECNA pattern associated with paroxysmal atrial tachyarrhythmias. However, when ICNA is recorded, we found that all episodes of paroxysmal atrial tachyarrhythmias were preceded by ICNA sometimes even without extrinsic nerve activity. Furthermore, the balance between sympathetic and parasympathetic nerve activities was shown to have an impact on progression from paroxysmal atrial fibrillation (AF) to persistent AF induced by intermittent rapid atrial pacing. Reducing the autonomic nerve activity by ablation of the stellate ganglion and cardiac branch of vagal nerve may reduce paroxysmal atrial tachyarrhythmias in ambulatory dogs. In addition, low-level vagus nerve stimulation (LL-VNS) can induce stellate ganglion remodeling, reducing stellate ganglion nerve activity (SGNA) and reduce the incidences of paroxysmal atrial tachyarrhythmias. We conclude that mapping autonomic nerve activity is feasible, and may provide new insights into cardiac arrhythmogenesis. This edition first published 2013

Original languageEnglish (US)
Title of host publicationCardiac Mapping
Subtitle of host publicationFourth Edition
Number of pages9
ISBN (Print)9780470670460
StatePublished - Dec 18 2012



  • Ablation
  • Atrial fibrillation
  • Autonomic nervous system
  • Ganglionated plexi
  • Nerve recording
  • Nerve stimulation
  • Neural modulation
  • Neural remodeling
  • Sympathetic
  • Tachyarrhythmias
  • Vagal

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Choi, E. K., Shen, M. J., Lin, S. F., Fishbein, M. C., Chen, L. S., & Chen, P. S. (2012). How to Map Autonomic Activity. In Cardiac Mapping: Fourth Edition (pp. 179-187). Wiley-Blackwell.