Autonomic Modulation of Atrial Fibrillation

Wei-Chung Tsai; Tien-Chi Hung; Takashi Kusayama; Seongwook Han; Michael C Fishbein; Lan S Chen; Peng-Sheng Chen

doi:10.1016/j.jacbts.2023.03.019

Autonomic Modulation of Atrial Fibrillation

JACC Basic Transl Sci. 2023 Jun 28;8(10):1398-1410. doi: 10.1016/j.jacbts.2023.03.019. eCollection 2023 Oct.

Authors

Wei-Chung Tsai¹, Tien-Chi Hung¹, Takashi Kusayama², Seongwook Han³, Michael C Fishbein⁴, Lan S Chen⁵, Peng-Sheng Chen⁵

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences Kanazawa, Kanazawa, Japan.
³ Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
⁴ Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA.
⁵ Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Abstract

The autonomic nervous system plays a vital role in cardiac arrhythmias, including atrial fibrillation (AF). Therefore, reducing the sympathetic tone via neuromodulation methods may be helpful in AF control. Myocardial ischemia is associated with increased sympathetic tone and incidence of AF. It is an excellent disease model to understand the neural mechanisms of AF and the effects of neuromodulation. This review summarizes the relationship between autonomic nervous system and AF and reviews methods and mechanisms of neuromodulation. This review proposes that noninvasive or minimally invasive neuromodulation methods will be most useful in the future management of AF.

Keywords: neuECG; neuroremodeling; skin sympathetic nerve activity; stellate ganglion; sympathetic nerve activity.

Publication types

Review