Is the Atrial Neural Plexis a Therapeutic Target in Atrial Fibrillation?

Eue Keun Choi, Peng-Sheng Chen

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Circumferential pulmonary vein isolation is the mainstay of atrial fibrillation (AF) ablation, but alternative approaches and techniques have been developed to improve the outcomes. One of these additional ablation targets are ganglionated plexi of the intrinsic cardiac autonomic system that contain a variety of sympathetic and parasympathetic neurons that communicate with the extrinsic cardiac autonomic nervous system. The ganglionated plexi of the heart do not serve as a simple relay station but could modulate the autonomic interaction between the extrinsic and intrinsic cardiac autonomic system. Intrinsic cardiac autonomic nerve activity is an invariable trigger of paroxysmal atrial tachyarrhythmia, including atrial fibrillation. Although multiple studies have shown that ganglionated plexi play an important role in initiating atrial fibrillation, there is no consensus on a standardized protocol for selecting target sites and determining how ganglionated plexi ablation can best be accomplished. Recent clinical trials have demonstrated the feasibility and efficacy of ganglionated plexi ablation in addition to pulmonary vein isolation, but novel technologies and strategies are necessary to improve the current ablation techniques in managing patients with atrial fibrillation. This review focuses on the relationship between atrial ganglionated plexi and atrial fibrillation and the potential benefits and limitations of ganglionated plexi ablation in the management of atrial fibrillation.

Original languageEnglish (US)
Pages (from-to)82-86
Number of pages5
JournalMethodist DeBakey cardiovascular journal
Volume11
Issue number2
DOIs
StatePublished - Apr 1 2015

Fingerprint

Atrial Fibrillation
Pulmonary Veins
Therapeutics
Ablation Techniques
Autonomic Pathways
Autonomic Nervous System
Tachycardia
Clinical Trials
Technology
Neurons

Keywords

  • atrial fibrillation
  • cardiac autonomic nervous system
  • catheter ablation
  • ganglionated plexi

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Is the Atrial Neural Plexis a Therapeutic Target in Atrial Fibrillation? / Choi, Eue Keun; Chen, Peng-Sheng.

In: Methodist DeBakey cardiovascular journal, Vol. 11, No. 2, 01.04.2015, p. 82-86.

Research output: Contribution to journalReview article

@article{6980f2b9efe648bc8e89236a3b784c66,
title = "Is the Atrial Neural Plexis a Therapeutic Target in Atrial Fibrillation?",
abstract = "Circumferential pulmonary vein isolation is the mainstay of atrial fibrillation (AF) ablation, but alternative approaches and techniques have been developed to improve the outcomes. One of these additional ablation targets are ganglionated plexi of the intrinsic cardiac autonomic system that contain a variety of sympathetic and parasympathetic neurons that communicate with the extrinsic cardiac autonomic nervous system. The ganglionated plexi of the heart do not serve as a simple relay station but could modulate the autonomic interaction between the extrinsic and intrinsic cardiac autonomic system. Intrinsic cardiac autonomic nerve activity is an invariable trigger of paroxysmal atrial tachyarrhythmia, including atrial fibrillation. Although multiple studies have shown that ganglionated plexi play an important role in initiating atrial fibrillation, there is no consensus on a standardized protocol for selecting target sites and determining how ganglionated plexi ablation can best be accomplished. Recent clinical trials have demonstrated the feasibility and efficacy of ganglionated plexi ablation in addition to pulmonary vein isolation, but novel technologies and strategies are necessary to improve the current ablation techniques in managing patients with atrial fibrillation. This review focuses on the relationship between atrial ganglionated plexi and atrial fibrillation and the potential benefits and limitations of ganglionated plexi ablation in the management of atrial fibrillation.",
keywords = "atrial fibrillation, cardiac autonomic nervous system, catheter ablation, ganglionated plexi",
author = "Choi, {Eue Keun} and Peng-Sheng Chen",
year = "2015",
month = "4",
day = "1",
doi = "10.14797/mdcj-11-2-82",
language = "English (US)",
volume = "11",
pages = "82--86",
journal = "Methodist DeBakey cardiovascular journal",
issn = "1947-6094",
publisher = "Methodist DeBakey Heart & Vascular Center",
number = "2",

}

TY - JOUR

T1 - Is the Atrial Neural Plexis a Therapeutic Target in Atrial Fibrillation?

AU - Choi, Eue Keun

AU - Chen, Peng-Sheng

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Circumferential pulmonary vein isolation is the mainstay of atrial fibrillation (AF) ablation, but alternative approaches and techniques have been developed to improve the outcomes. One of these additional ablation targets are ganglionated plexi of the intrinsic cardiac autonomic system that contain a variety of sympathetic and parasympathetic neurons that communicate with the extrinsic cardiac autonomic nervous system. The ganglionated plexi of the heart do not serve as a simple relay station but could modulate the autonomic interaction between the extrinsic and intrinsic cardiac autonomic system. Intrinsic cardiac autonomic nerve activity is an invariable trigger of paroxysmal atrial tachyarrhythmia, including atrial fibrillation. Although multiple studies have shown that ganglionated plexi play an important role in initiating atrial fibrillation, there is no consensus on a standardized protocol for selecting target sites and determining how ganglionated plexi ablation can best be accomplished. Recent clinical trials have demonstrated the feasibility and efficacy of ganglionated plexi ablation in addition to pulmonary vein isolation, but novel technologies and strategies are necessary to improve the current ablation techniques in managing patients with atrial fibrillation. This review focuses on the relationship between atrial ganglionated plexi and atrial fibrillation and the potential benefits and limitations of ganglionated plexi ablation in the management of atrial fibrillation.

AB - Circumferential pulmonary vein isolation is the mainstay of atrial fibrillation (AF) ablation, but alternative approaches and techniques have been developed to improve the outcomes. One of these additional ablation targets are ganglionated plexi of the intrinsic cardiac autonomic system that contain a variety of sympathetic and parasympathetic neurons that communicate with the extrinsic cardiac autonomic nervous system. The ganglionated plexi of the heart do not serve as a simple relay station but could modulate the autonomic interaction between the extrinsic and intrinsic cardiac autonomic system. Intrinsic cardiac autonomic nerve activity is an invariable trigger of paroxysmal atrial tachyarrhythmia, including atrial fibrillation. Although multiple studies have shown that ganglionated plexi play an important role in initiating atrial fibrillation, there is no consensus on a standardized protocol for selecting target sites and determining how ganglionated plexi ablation can best be accomplished. Recent clinical trials have demonstrated the feasibility and efficacy of ganglionated plexi ablation in addition to pulmonary vein isolation, but novel technologies and strategies are necessary to improve the current ablation techniques in managing patients with atrial fibrillation. This review focuses on the relationship between atrial ganglionated plexi and atrial fibrillation and the potential benefits and limitations of ganglionated plexi ablation in the management of atrial fibrillation.

KW - atrial fibrillation

KW - cardiac autonomic nervous system

KW - catheter ablation

KW - ganglionated plexi

UR - http://www.scopus.com/inward/record.url?scp=84992205785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992205785&partnerID=8YFLogxK

U2 - 10.14797/mdcj-11-2-82

DO - 10.14797/mdcj-11-2-82

M3 - Review article

C2 - 26306124

AN - SCOPUS:84992205785

VL - 11

SP - 82

EP - 86

JO - Methodist DeBakey cardiovascular journal

JF - Methodist DeBakey cardiovascular journal

SN - 1947-6094

IS - 2

ER -