Role of the autonomic nervous system in atrial fibrillation

Pathophysiology and therapy

Peng-Sheng Chen, Lan Chen, Michael C. Fishbein, Shien-Fong Lin, Stanley Nattel

Research output: Contribution to journalArticle

200 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1500-1515
Number of pages16
JournalCirculation Research
Volume114
Issue number9
DOIs
StatePublished - Apr 25 2014

Fingerprint

Autonomic Nervous System
Atrial Fibrillation
Autonomic Pathways
Tachycardia
Cardiac Arrhythmias
Therapeutics
Vagus Nerve Stimulation
Biological Therapy
Sympathectomy
Baroreflex
Electrophysiology
Incidence
Maintenance
Technology
Kidney
Drug Therapy
Skin

Keywords

  • Heart failure
  • myocardial infarction

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Role of the autonomic nervous system in atrial fibrillation : Pathophysiology and therapy. / Chen, Peng-Sheng; Chen, Lan; Fishbein, Michael C.; Lin, Shien-Fong; Nattel, Stanley.

In: Circulation Research, Vol. 114, No. 9, 25.04.2014, p. 1500-1515.

Research output: Contribution to journalArticle

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