Central Sympathetic Inhibition: a Neglected Approach for Treatment of Cardiac Arrhythmias?

Francesca Cagnoni, M. Destro, E. Bontempelli, G. Locatelli, Dagmara Hering, Markus Schlaich

    Research output: Contribution to journalReview article

    2 Citations (Scopus)
    187 Downloads (Pure)

    Abstract

    © 2016, Springer Science+Business Media New York. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Overactivation of the sympathetic nervous system (SNS) plays an important role in the pathogenesis of comorbidities related to AF such as hypertension, congestive heart failure, obesity, insulin resistance, and obstructive sleep apnea. Methods that reduce sympathetic drive, such as centrally acting sympatho-inhibitory agents, have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias, suggesting that neuromodulation may be helpful in controlling AF. Moxonidine acts centrally to reduce activity of the SNS, and clinical trials indicate that this is associated with a decreased AF burden in hypertensive patients with paroxysmal AF and reduced post-ablation recurrence of AF in patients with hypertension who underwent pulmonary vein isolation (PVI). Furthermore, device-based approaches to reduce sympathetic drive, such as renal denervation, have yielded promising results in the prevention and treatment of cardiac arrhythmias. In light of these recent findings, targeting elevated sympathetic drive with either pharmacological or device-based approaches has become a focus of clinical research. Here, we review the data currently available to explore the potential utility of sympatho-inhibitory therapies in the prevention and treatment of cardiac arrhythmias.
    Original languageEnglish
    Article number13
    Pages (from-to)1-11
    Number of pages11
    JournalCurrent Hypertension Reports
    Volume18
    Issue number2
    Early online date19 Jan 2016
    DOIs
    Publication statusPublished - Feb 2016

    Fingerprint

    Atrial Fibrillation
    Cardiac Arrhythmias
    moxonidine
    Sympathetic Nervous System
    Therapeutics
    Hypertension
    Equipment and Supplies
    Pulmonary Veins
    Denervation
    Obstructive Sleep Apnea
    Insulin Resistance
    Comorbidity
    Heart Failure
    Obesity
    Clinical Trials
    Pharmacology
    Kidney
    Recurrence
    Incidence
    Research

    Cite this

    Cagnoni, Francesca ; Destro, M. ; Bontempelli, E. ; Locatelli, G. ; Hering, Dagmara ; Schlaich, Markus. / Central Sympathetic Inhibition: a Neglected Approach for Treatment of Cardiac Arrhythmias?. In: Current Hypertension Reports. 2016 ; Vol. 18, No. 2. pp. 1-11.
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    abstract = "{\circledC} 2016, Springer Science+Business Media New York. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Overactivation of the sympathetic nervous system (SNS) plays an important role in the pathogenesis of comorbidities related to AF such as hypertension, congestive heart failure, obesity, insulin resistance, and obstructive sleep apnea. Methods that reduce sympathetic drive, such as centrally acting sympatho-inhibitory agents, have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias, suggesting that neuromodulation may be helpful in controlling AF. Moxonidine acts centrally to reduce activity of the SNS, and clinical trials indicate that this is associated with a decreased AF burden in hypertensive patients with paroxysmal AF and reduced post-ablation recurrence of AF in patients with hypertension who underwent pulmonary vein isolation (PVI). Furthermore, device-based approaches to reduce sympathetic drive, such as renal denervation, have yielded promising results in the prevention and treatment of cardiac arrhythmias. In light of these recent findings, targeting elevated sympathetic drive with either pharmacological or device-based approaches has become a focus of clinical research. Here, we review the data currently available to explore the potential utility of sympatho-inhibitory therapies in the prevention and treatment of cardiac arrhythmias.",
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    Central Sympathetic Inhibition: a Neglected Approach for Treatment of Cardiac Arrhythmias? / Cagnoni, Francesca; Destro, M.; Bontempelli, E.; Locatelli, G.; Hering, Dagmara; Schlaich, Markus.

    In: Current Hypertension Reports, Vol. 18, No. 2, 13, 02.2016, p. 1-11.

    Research output: Contribution to journalReview article

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    AU - Destro, M.

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    N2 - © 2016, Springer Science+Business Media New York. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Overactivation of the sympathetic nervous system (SNS) plays an important role in the pathogenesis of comorbidities related to AF such as hypertension, congestive heart failure, obesity, insulin resistance, and obstructive sleep apnea. Methods that reduce sympathetic drive, such as centrally acting sympatho-inhibitory agents, have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias, suggesting that neuromodulation may be helpful in controlling AF. Moxonidine acts centrally to reduce activity of the SNS, and clinical trials indicate that this is associated with a decreased AF burden in hypertensive patients with paroxysmal AF and reduced post-ablation recurrence of AF in patients with hypertension who underwent pulmonary vein isolation (PVI). Furthermore, device-based approaches to reduce sympathetic drive, such as renal denervation, have yielded promising results in the prevention and treatment of cardiac arrhythmias. In light of these recent findings, targeting elevated sympathetic drive with either pharmacological or device-based approaches has become a focus of clinical research. Here, we review the data currently available to explore the potential utility of sympatho-inhibitory therapies in the prevention and treatment of cardiac arrhythmias.

    AB - © 2016, Springer Science+Business Media New York. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Overactivation of the sympathetic nervous system (SNS) plays an important role in the pathogenesis of comorbidities related to AF such as hypertension, congestive heart failure, obesity, insulin resistance, and obstructive sleep apnea. Methods that reduce sympathetic drive, such as centrally acting sympatho-inhibitory agents, have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias, suggesting that neuromodulation may be helpful in controlling AF. Moxonidine acts centrally to reduce activity of the SNS, and clinical trials indicate that this is associated with a decreased AF burden in hypertensive patients with paroxysmal AF and reduced post-ablation recurrence of AF in patients with hypertension who underwent pulmonary vein isolation (PVI). Furthermore, device-based approaches to reduce sympathetic drive, such as renal denervation, have yielded promising results in the prevention and treatment of cardiac arrhythmias. In light of these recent findings, targeting elevated sympathetic drive with either pharmacological or device-based approaches has become a focus of clinical research. Here, we review the data currently available to explore the potential utility of sympatho-inhibitory therapies in the prevention and treatment of cardiac arrhythmias.

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