Document Detail

The intrinsic autonomic nervous system in atrial fibrillation: a review.
MedLine Citation:
PMID:  22778995     Owner:  NLM     Status:  PubMed-not-MEDLINE    
The procedure of catheter ablation for the treatment of drug resistant atrial fibrillation (AF) has evolved but still relies on lesion sets intended to isolate areas of focal firing, mainly the myocardial sleeves of the pulmonary veins (PVs), from the rest of the atria. However the success rates for this procedure have varied inversely with the type of AF. At best success rates have been 20 to 30% below that of other catheter ablation procedures for Wolff-Parkinson-White syndrome, atrioventricular junctional re-entrant tachycardia and atrial flutter. Basic and clinical evidence has emerged suggesting a critical role of the ganglionated plexi (GP) at the PV-atrial junctions in the initiation and maintenance of the focal form of AF. At present the highest success rates have been obtained with the combination of PV isolation and GP ablation both as catheter ablation or minimally invasive surgical procedures. Various lines of evidence from earlier and more recent reports provide that both neurally based and myocardially based forms of AF can separately dominate or coexist within the context of atrial remodeling. Future studies are focusing on non-pharmacological, non-ablative approaches for the prevention and treatment of AF in order to avoid the substantive complications of both these regimens.
Bo He; Benjamin J Scherlag; Hiroshi Nakagawa; Ralph Lazzara; Sunny S Po
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Publication Detail:
Type:  Journal Article     Date:  2012-06-19
Journal Detail:
Title:  ISRN cardiology     Volume:  2012     ISSN:  2090-5599     ISO Abbreviation:  ISRN Cardiol     Publication Date:  2012  
Date Detail:
Created Date:  2012-07-10     Completed Date:  2012-08-23     Revised Date:  2013-04-01    
Medline Journal Info:
Nlm Unique ID:  101566293     Medline TA:  ISRN Cardiol     Country:  Egypt    
Other Details:
Languages:  eng     Pagination:  490674     Citation Subset:  -    
Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan, Hubei 430060, China.
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