Document Detail


Autonomic aspects of arrhythmogenesis: the enduring and the new.
MedLine Citation:
PMID:  14688627     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Recent progress in understanding the role of the autonomic nervous system in the development of cardiac arrhythmias is reviewed. The focus is on the translation of basic principles of neural control of heart rhythm that have emerged from experimental studies to clinical applications.
RECENT FINDINGS: Recent studies have made significant strides in defining the function of intrinsic cardiac innervation and the importance of nerve sprouting in electrical remodeling. A recurring theme is that heterogeneity of sympathetic innervation in response to injury is highly arrhythmogenic. In addition, both sympathetic and parasympathetic influences on ion channel activity have been found to accentuate electrical heterogeneities and thus to contribute to arrhythmogenesis in the long QT and Brugada syndromes. In the clinic, heart rate variability continues to be a useful tool in delineating pathophysiologic changes that result from the progression of heart disease and the impact of diabetic neuropathy. Heart rate turbulence, a noninvasive indicator of baroreceptor sensitivity, has emerged as a simple, practical tool to assess risk for cardiovascular mortality in patients with ischemic heart disease and heart failure. Evidence of the proarrhythmic influence of behavioral stress has been further bolstered by defibrillator discharge studies and ambulatory ECG-based T-wave alternans measurement.
SUMMARY: The results of recent investigations underscore the importance of the autonomic influences as triggers of arrhythmia and provide important mechanistic insights into the ionic and cellular mechanisms involved.
Authors:
Richard L Verrier; Charles Antzelevitch
Related Documents :
22878807 - Disruption of atherosclerotic neointima seven years after bare metal stent deployment.
8677867 - Linear and nonlinear dynamics of heart rate variability after acute myocardial infarcti...
2418307 - Clonidine prevents the sympathetic initiation and aggravation of poststenotic myocardia...
17013267 - Central neuroaxis blockade and coronary circulation.
22100027 - Prognostic value of uric acid in patients with st-elevated myocardial infarction underg...
18725487 - Dynamic mechanism for initiation of ventricular fibrillation in vivo.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  19     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-22     Completed Date:  2004-06-03     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-11     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / physiopathology*,  psychology
Autonomic Nervous System / physiology,  physiopathology*
Electrocardiography
Heart / innervation
Heart Rate / physiology*
Humans
Parasympathetic Nervous System / physiopathology
Pressoreceptors / physiopathology
Sympathetic Nervous System / physiopathology
Grant Support
ID/Acronym/Agency:
HL 47678/HL/NHLBI NIH HHS; R01 HL047678/HL/NHLBI NIH HHS; R01 HL63968/HL/NHLBI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Caspase inhibition after neonatal ischemia in the rat brain.
Next Document:  An update on clinical trials in pacing: is dual chamber pacing better?