Autonomic modulation of ventricular electrical activity: recent developments and clinical implications
| Autor: | Olujimi A. Ajijola, Marc A. Vos, Valerie Y H van Weperen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Neural remodeling
medicine.medical_specialty Neurology Vagus Nerve Stimulation Heart Ventricles Vagal nerve Clinical Sciences Cardiac electrophysiology Arrhythmogenesis Review Article Arrhythmias Cardiovascular Autonomic Nervous System Sympathetic Denervation medicine Humans General Clinical Medicine Endocrine and Autonomic Systems business.industry Autonomic tone Neurosciences Arrhythmias Cardiac Heart Blockade Heart Disease Autonomic imbalance Sympathetic nerves Neurology (clinical) Autonomic modulation business Cardiac Neuroscience |
| Zdroj: | Clinical Autonomic Research Clinical autonomic research : official journal of the Clinical Autonomic Research Society, vol 31, iss 6 |
| ISSN: | 1619-1560 0959-9851 |
| Popis: | PurposeThis review aimed to provide a complete overview of the current stance and recent developments in antiarrhythmic neuromodulatory interventions, focusing on lifethreatening vetricular arrhythmias.MethodsBoth preclinical studies and clinical studies were assessed to highlight the gaps in knowledge that remain to be answered and the necessary steps required to properly translate these strategies to the clinical setting.ResultsCardiac autonomic imbalance, characterized by chronic sympathoexcitation and parasympathetic withdrawal, destabilizes cardiac electrophysiology and promotes ventricular arrhythmogenesis. Therefore, neuromodulatory interventions that target the sympatho-vagal imbalance have emerged as promising antiarrhythmic strategies. These strategies are aimed at different parts of the cardiac neuraxis and directly or indirectly restore cardiac autonomic tone. These interventions include pharmacological blockade of sympathetic neurotransmitters and neuropeptides, cardiac sympathetic denervation, thoracic epidural anesthesia, and spinal cord and vagal nerve stimulation.ConclusionNeuromodulatory strategies have repeatedly been demonstrated to be highly effective and very promising anti-arrhythmic therapies. Nevertheless, there is still much room to gain in our understanding of neurocardiac physiology, refining the current neuromodulatory strategic options and elucidating the chronic effects of many of these strategic options. |
| Databáze: | OpenAIRE |
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