scholarly journals Vagal Reactions during Cryoballoon-Based Pulmonary Vein Isolation: A Clue for Autonomic Nervous System Modulation?

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Michaël Peyrol ◽  
Jérémie Barraud ◽  
Linda Koutbi ◽  
Baptiste Maille ◽  
Lory Trevisan ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Pulmonary Vein ◽  
Observational Studies ◽  
Pulmonary Veins ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous ◽  
Ganglionated Plexi ◽  
Vast Network

Although paroxysmal atrial fibrillation (AF) is known to be initiated by rapid firing of pulmonary veins (PV) and non-PV triggers, the crucial role of cardiac autonomic nervous system (ANS) in the initiation and maintenance of AF has long been appreciated in both experimental and clinical studies. The cardiac intrinsic ANS is composed of ganglionated plexi (GPs), located close to the left atrium-pulmonary vein junctions and a vast network of interconnecting neurons. Ablation strategies aiming for complete PV isolation (PVI) remain the cornerstone of AF ablation procedures. However, several observational studies and few randomized studies have suggested that GP ablation, as an adjunctive strategy, might achieve better clinical outcomes in patients undergoing radiofrequency-based PVI for both paroxysmal and nonparoxysmal AF. In these patients, vagal reactions (VR) such as vagally mediated bradycardia or asystole are thought to reflect intrinsic cardiac ANS modulation and/or denervation. Vagal reactions occurring during cryoballoon- (CB-) based PVI have been previously reported; however, little is known on resulting ANS modulation and/or prevalence and significance of vagal reactions during PVI with the CB technique. We conducted a review of prevalence, putative mechanisms, and significance of VR during CB-based PVI.

scholarly journals Dissociated pulmonary vein potentials: Expression of the cardiac autonomic nervous system following pulmonary vein isolation?

2015 ◽  
Vol 1 (6) ◽  
pp. 401-405
Author(s):  
Andreas Kyriacou ◽  
Sajad Hayat ◽  
Norman Qureshi ◽  
Nicholas S. Peters ◽  
Prapa Kanagaratnam ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous

scholarly journals Targeting the autonomic nervous system during AF ablation: should we fight or take flight?

2020 ◽  
Author(s):  
Tolga Aksu ◽  
Dhiraj Gupta
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Action Potential ◽  
Action Potential Duration ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Autonomic Nerve ◽  
High Frequency Stimulation ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous

Demonstration that the myocardial sleeves of the pulmonary veins (PVs) are the main triggering and maintaining foci for paroxysmal atrial fibrillation (AF) have stimulated studies investigating electrophysiological properties of PVs and the adjacent left atrial (LA) myocardium. It has been shown that PV myocytes have a shorter action potential duration and are more prone to effects of local autonomic nerve stimulation in terms of shortening of action potential duration, early after depolarization formation and triggered firing compared to left atrial myocytes (1). The intrinsic cardiac autonomic nervous system (ICANS) forms clusters of neurons called ganglionic plexi (GPs), and studies using histologic examination of heart sections have shown that these GPs are localized preferentially at certain epicardial sites adjacent to the left and right atria (2). The precise role of ICANS in AF continues to be an area of intense research (3), and matters are not helped by the uncertainty regarding the best way to identify and target ICANS peri-procedurally. As there can be significant variability of GP sites in individual patients, endocardial high-frequency stimulation (HFS) has been used to aid their localization in the electrophysiology laboratory (4).

The Autonomic Nervous System and Atrial Fibrillation: The Roles of Pulmonary Vein Isolation and Ganglionated Plexi Ablation

2009 ◽  
Vol 1 (8) ◽  
Author(s):  
Benjamin J Scherlag ◽  
Hiroshi Nakagawa ◽  
Eugene Patterson ◽  
Warren M Jackman ◽  
Ralph Lazzara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Autonomic Nervous ◽  
Ganglionated Plexi

scholarly journals Sleep Apnea and Atrial Fibrillation: Role of the Cardiac Autonomic Nervous System

2021 ◽  
pp. 48-51
Author(s):  
Liliana Tavares ◽  
Adi Lador ◽  
Miguel Valderrábano
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Sleep Apnea ◽  
The United States ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous

Sleep apnea is highly associated with atrial fibrillation (AF), and both diseases are highly prevalent in the United States. The mechanistic underpinnings that contribute to their association remain uncertain, but numerous possible mechanisms have been proposed, including dysfunction of the cardiac autonomic nervous system (ANS). Studies have reported that apnea induces hyperactivity of the ANS, leading to increases in AF susceptibility. This review compiles the latest evidence on the role of the ANS in sleep-apnea-induced AF.

scholarly journals Intrinsic Cardiac Autonomic Nervous System: what do clinical electrophysiologists need to know about the ‘heart brain’?

2021 ◽  
Author(s):  
Tolga Aksu ◽  
Rakesh Gopinathannair ◽  
Dhiraj Gupta ◽  
Dainius Pauza
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Cardiac Arrhythmias ◽  
Human Heart ◽  
Nerve Fibers ◽  
Major Contributor ◽  
Novel Therapy ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous

It is increasingly recognized that the autonomic nervous system (ANS) is a major contributor in many cardiac arrhythmias. Cardiac ANS can be divided into extrinsic and intrinsic parts according to the course of nerve fibers and localization of ganglia and neuron bodies. Although the role of extrinsic part has historically gained more attention, the intrinsic cardiac ANS may affect cardiac function independently as well as influence the effects of the extrinsic nerves. Catheter based modulation of the intrinsic cardiac ANS is emerging as a novel therapy for management of patients with brady and tachy arrhythmias resulting from hyperactive vagal activation. However, distribution of intrinsic cardiac nerve plexus in the human heart and the functional properties of intrinsic cardiac neural elements remain insufficiently understood. The present review aims to bring the clinical and anatomical elements of the ICANS together, by reviewing neuroanatomical terminologies and physiological functions, in order to guide the clinical electrophysiologist in the catheter lab, and to serve as a reference for further research.

scholarly journals Cardiac Autonomic Denervation for Ablation of Atrial Fibrillation

2014 ◽  
Vol 3 (2) ◽  
pp. 113 ◽  
Author(s):  
George D Katritsis ◽  
Demosthenes G Katritsis ◽  
◽  
Keyword(s):  
Atrial Fibrillation ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Maze Procedure ◽  
Autonomic Denervation ◽  
Autonomic Nervous ◽  
Ganglionated Plexi

The influence of the autonomic nervous system (ANS) on triggering and perpetuation of atrial fibrillation (AF) is well established. Ganglionated plexi (GP) ablation achieves autonomic denervation by affecting both the parasympathetic and sympathetic components of the ANS. GP ablation can be accomplished endocardially or epicardially, i.e. during the maze procedure or thoracoscopic approaches. Recent evidence indicates that anatomic GP ablation at relevant atrial sites appears to be safe and improves the results of pulmonary vein isolation in patients with paroxysmal and persistent AF.

scholarly journals Effects of Pulmonary Vein Isolation on the Cardiac Autonomic Nervous System

2019 ◽  
Vol 78 (1) ◽  
pp. 33-39
Author(s):  
Ryuta Watanabe ◽  
Ichiro Watanabe ◽  
Yasuo Okumura ◽  
Koichi Nagashima ◽  
Keiko Takahashi ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous
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