Catheter Ablation of Cardiac Autonomic Nerves for Prevention of Vagal Atrial Fibrillation

Abstract

-Transvascular atrial parasympathetic nerve system modification by RFCA abolishes vagally mediated AF. This antifibrillatory procedure may provide a foundation for investigating the usefulness of neural ablation in chronic animal models of AF and eventually in patients with AF and high vagal tone.

Differences in atrial fibrillation properties under vagal nerve stimulation versus atrial tachycardia remodeling

“…In analogy, we observed higher DFs and permanent AF only in the VS group. Our results reinforce the idea of ablation of vagal ganglia in order to reduce duration and number of AF episodes 138 . However, the importance and the timing of such ablation (simultaneously with PV ablation to prevent recurrences and remodeling, or in a second procedure) have still to be defined.…”

“…An interesting correlation of CFAEs with DFs and consequently vagal ganglia was also suggested by the electroanatomical mapping performed in our study. Therefore, based also on previous observations 72,73,138,143 , ablation of vagal ganglia during AF ablation could also be advantageous.…”

Atrial tachycardia induces remodelling of muscarinic receptors and their coupled potassium currents in canine left atrial and pulmonary vein cardiomyocytes

“…radiofrequency catheter ablation suppresses vagally mediated AF (Schauerte et al, 2000;Pappone et al, 2004), which suggests that a decrease in response to parasymparathetic stimulation might have an antiarrhythmic effect. Thus, the reduction of I KM2 , I KM3 and I KM4 that we observed may be an intrinsic protective mechanism to counteract the AF-promoting consequences of AT remodelling.…”

“…Both parasympathetic tone and remodelling of atrial ion channel expression play an important role in the pathophysiology of atrial fibrillation (AF) (Schauerte et al, 2000;Nattel, 2002). Muscarinic cholinergic receptors (mAChRs) mediate parasympathetic control of cardiac function, including electrical activity and mechanical contraction.…”

Modulação eletrofisiológica das aurículas e veias pulmonares: interação da estimulação simpática e parassimpática na inducibilidade de fibrilhação aguda auricular num modelo experimental in vivo

“…No entanto, uma parte importante desta atividade experimental tem sido levada a cabo em modelos de coração isolado. É reconhecida a necessidade de esclarecer a relação entre a ativação autonómica aguda in vivo e a vulnerabilidade para iniciar e manter a FA, nomeadamente porque a modificação da inervação autonómica, sobretudo em áreas cardíacas com grande densidade de terminações nervosas, pode ter implicações potenciais na terapêutica ablativa da FA 14,19,20 .…”