Document Detail


Vagal modulation of cardiac ventricular arrhythmia.
MedLine Citation:
PMID:  24014808     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Sudden cardiac death remains a significant unresolved clinical problem with many of the deaths due to malignant ventricular arrhythmias. Markers of abnormal autonomic function have been shown to be strong prognostic predictors highlighting the important relationship between reduced vagal tone and malignant ventricular arrhythmias such as ventricular fibrillation in cardiac patients. Exploring the mechanisms underlying the autonomic modulation of ventricular fibrillation, our group has shown that vagus nerve stimulation protects against ventricular fibrillation in the innervated isolated heart preparation. We have provided direct evidence that nitric oxide (NO) is released in the ventricle with cervical vagus nerve stimulation and NO mediates the antifibrillatory actions of vagus nerve stimulation in the ventricle. Classical physiology teaches that vagal post-ganglionic nerves modulate the heart via acetylcholine acting at muscarinic receptors and dogmatically that there is little vagal effect in the ventricle as innervation was believed to be sparse. Mounting evidence from many species now support the presence of a rich vagal innervation in the ventricle. Data from our group that the protective actions of vagus nerve stimulation against ventricular fibrillation and NO release are preserved in the presence of muscarinic block supports the notion that a population of nitrergic neurons could be responsible. This potentially exploitable downstream pathway together with the availability of vagus nerve stimulators make it an exciting time to directly investigate the development of an effective strategy of vagal protection against ventricular fibrillation in the clinical setting.
Authors:
G Andre Ng
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-6
Journal Detail:
Title:  Experimental physiology     Volume:  -     ISSN:  1469-445X     ISO Abbreviation:  Exp. Physiol.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9002940     Medline TA:  Exp Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University of Leicester, United Kingdom.
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