Sympathetic Nervous System Activation and Its Modulation: Role in Atrial Fibrillation

Research output: Contribution to journalReview article

Abstract

The autonomic nervous system (ANS) has a significant influence on the structural integrity and electrical conductivity of the atria. Aberrant activation of the sympathetic nervous system can induce heterogeneous changes with arrhythmogenic potential which can result in atrial tachycardia, atrial tachyarrhythmias and atrial fibrillation (AF). Methods to modulate autonomic activity primarily through reduction of sympathetic outflow reduce the incidence of spontaneous or induced atrial arrhythmias in animal models and humans, suggestive of the potential application of such strategies in the management of AF. In this review we focus on the relationship between the ANS, sympathetic overdrive and the pathophysiology of AF, and the potential of sympathetic neuromodulation in the management of AF. We conclude that sympathetic activity plays an important role in the initiation and maintenance of AF, and modulating ANS function is an important therapeutic approach to improve the management of AF in selected categories of patients. Potential therapeutic applications include pharmacological inhibition with central and peripheral sympatholytic agents and various device based approaches. While the role of the sympathetic nervous system has long been recognized, new developments in science and technology in this field promise exciting prospects for the future.

Original languageEnglish
Article number1058
Number of pages16
JournalFrontiers in Neuroscience
Volume12
DOIs
Publication statusPublished - 23 Jan 2019

Cite this

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title = "Sympathetic Nervous System Activation and Its Modulation: Role in Atrial Fibrillation",
abstract = "The autonomic nervous system (ANS) has a significant influence on the structural integrity and electrical conductivity of the atria. Aberrant activation of the sympathetic nervous system can induce heterogeneous changes with arrhythmogenic potential which can result in atrial tachycardia, atrial tachyarrhythmias and atrial fibrillation (AF). Methods to modulate autonomic activity primarily through reduction of sympathetic outflow reduce the incidence of spontaneous or induced atrial arrhythmias in animal models and humans, suggestive of the potential application of such strategies in the management of AF. In this review we focus on the relationship between the ANS, sympathetic overdrive and the pathophysiology of AF, and the potential of sympathetic neuromodulation in the management of AF. We conclude that sympathetic activity plays an important role in the initiation and maintenance of AF, and modulating ANS function is an important therapeutic approach to improve the management of AF in selected categories of patients. Potential therapeutic applications include pharmacological inhibition with central and peripheral sympatholytic agents and various device based approaches. While the role of the sympathetic nervous system has long been recognized, new developments in science and technology in this field promise exciting prospects for the future.",
keywords = "autonomic nervous system, hypertension, neuromodulation, atrial fibrillation, sympathetic overdrive, THORACIC EPIDURAL-ANESTHESIA, EPICARDIAL ADIPOSE-TISSUE, LEFT-VENTRICULAR HYPERTROPHY, GANGLIONATED PLEXI ABLATION, PULMONARY VEIN ISOLATION, OBSTRUCTIVE SLEEP-APNEA, LEFT STELLATE GANGLION, HEART-FAILURE, SINUS RHYTHM, RISK-FACTORS",
author = "Revathy Carnagarin and Kiuchi, {Marcio G.} and Ho, {Jan K.} and Matthews, {Vance B.} and Schlaich, {Markus P.}",
year = "2019",
month = "1",
day = "23",
doi = "10.3389/fnins.2018.01058",
language = "English",
volume = "12",
journal = "Frontiers in Neuroscience",
issn = "1662-4548",
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Sympathetic Nervous System Activation and Its Modulation : Role in Atrial Fibrillation. / Carnagarin, Revathy; Kiuchi, Marcio G.; Ho, Jan K.; Matthews, Vance B.; Schlaich, Markus P.

In: Frontiers in Neuroscience, Vol. 12, 1058, 23.01.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Sympathetic Nervous System Activation and Its Modulation

T2 - Role in Atrial Fibrillation

AU - Carnagarin, Revathy

AU - Kiuchi, Marcio G.

AU - Ho, Jan K.

AU - Matthews, Vance B.

AU - Schlaich, Markus P.

PY - 2019/1/23

Y1 - 2019/1/23

N2 - The autonomic nervous system (ANS) has a significant influence on the structural integrity and electrical conductivity of the atria. Aberrant activation of the sympathetic nervous system can induce heterogeneous changes with arrhythmogenic potential which can result in atrial tachycardia, atrial tachyarrhythmias and atrial fibrillation (AF). Methods to modulate autonomic activity primarily through reduction of sympathetic outflow reduce the incidence of spontaneous or induced atrial arrhythmias in animal models and humans, suggestive of the potential application of such strategies in the management of AF. In this review we focus on the relationship between the ANS, sympathetic overdrive and the pathophysiology of AF, and the potential of sympathetic neuromodulation in the management of AF. We conclude that sympathetic activity plays an important role in the initiation and maintenance of AF, and modulating ANS function is an important therapeutic approach to improve the management of AF in selected categories of patients. Potential therapeutic applications include pharmacological inhibition with central and peripheral sympatholytic agents and various device based approaches. While the role of the sympathetic nervous system has long been recognized, new developments in science and technology in this field promise exciting prospects for the future.

AB - The autonomic nervous system (ANS) has a significant influence on the structural integrity and electrical conductivity of the atria. Aberrant activation of the sympathetic nervous system can induce heterogeneous changes with arrhythmogenic potential which can result in atrial tachycardia, atrial tachyarrhythmias and atrial fibrillation (AF). Methods to modulate autonomic activity primarily through reduction of sympathetic outflow reduce the incidence of spontaneous or induced atrial arrhythmias in animal models and humans, suggestive of the potential application of such strategies in the management of AF. In this review we focus on the relationship between the ANS, sympathetic overdrive and the pathophysiology of AF, and the potential of sympathetic neuromodulation in the management of AF. We conclude that sympathetic activity plays an important role in the initiation and maintenance of AF, and modulating ANS function is an important therapeutic approach to improve the management of AF in selected categories of patients. Potential therapeutic applications include pharmacological inhibition with central and peripheral sympatholytic agents and various device based approaches. While the role of the sympathetic nervous system has long been recognized, new developments in science and technology in this field promise exciting prospects for the future.

KW - autonomic nervous system

KW - hypertension

KW - neuromodulation

KW - atrial fibrillation

KW - sympathetic overdrive

KW - THORACIC EPIDURAL-ANESTHESIA

KW - EPICARDIAL ADIPOSE-TISSUE

KW - LEFT-VENTRICULAR HYPERTROPHY

KW - GANGLIONATED PLEXI ABLATION

KW - PULMONARY VEIN ISOLATION

KW - OBSTRUCTIVE SLEEP-APNEA

KW - LEFT STELLATE GANGLION

KW - HEART-FAILURE

KW - SINUS RHYTHM

KW - RISK-FACTORS

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DO - 10.3389/fnins.2018.01058

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JO - Frontiers in Neuroscience

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SN - 1662-4548

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