Neuromodulation for cardiac arrhythmia

Hou, Yuemei; Zhou, Qina; Po, Sunny S.

doi:10.1016/j.hrthm.2015.10.001

Cited by 60 publications

(59 citation statements)

References 103 publications

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“…Many studies have demonstrated the impact of the ANS imbalance in the initiation and maintenance of AF [2,11]. The experimental data has shown the effect of disturbance of sympathetic innervation of the heart on the vulnerability of the left atrium for arrhythmogenic triggers arising from pulmonary veins [2].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of CZT SPECT imaging for cardiac sympathetic innervation in healthy individuals and patients with atrial fibrillation

Минин¹,

Nikitin²,

Шабанов³

et al. 2018

Russ Open Med J

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Background -Cadmium zinc telluride (CZT) solid-state detectors have been recently introduced in the field of nuclear medicine in cardiology. The aim of the current study was to investigate the scintigraphic patterns of total uptake and the regional distribution of iodine-123 metaiodobenzylguanidine ( 123 I-mIBG) in healthy volunteers and patients with atrial fibrillation (AF) using a gamma camera equipped CZT detectors. Material and Methods -The total number of included subjects was 30 (15 patients with a paroxysmal form of AF and 15 healthy volunteers). Using a novel single-photon emission computed tomography (SPECT) cardiac dedicated gamma camera equipped CZTdetectors the scintigraphy was performed 15 minutes and 4 hours after intravenous administration of norepinephrine structural analogue 123 I-mIBG. Thus, data from early and delayed phases were obtained. The heart-to-mediastinum ratio of I-mIBG uptake defects in LV myocardium were detected as compared with 8 (53%) healthy individuals (p<0.05). The healthy volunteers showed no significant 123 I-mIBG uptake defect in delayed scans compared with a median result in patients with AF (p<0.001). Conclusion -SPECT gamma camera with CZT-detectors is suitable to obtain qualitative tomographic slices of the myocardium and to assess regional changes in sympathetic innervation of the heart, which can be the early signs of an imbalance in the autonomic nervous system. Therefore, this camera may be useful for managing patients with various forms of AF.

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Section: Discussionmentioning

confidence: 99%

Evaluation of CZT SPECT imaging for cardiac sympathetic innervation in healthy individuals and patients with atrial fibrillation

Минин¹,

Nikitin²,

Шабанов³

et al. 2018

Russ Open Med J

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“…111,112 Side effects from the procedure include infection, dysphagia, hoarseness, cough, and pain. 86 A reduction in sudden cardiac death from ventricular arrhythmias has been demonstrated with vagal stimulation in a healed infarct canine model subjected to repeat ischemia. 113 First human cardiac application was described in 8 patients for the indication of heart failure using CardioFit stimulators.…”

Section: Neuraxial Modulation To Reduce Risk Of Scdmentioning

confidence: 99%

“…86 Similar to TEA, SCS acts in the epidural space of T1–T4, but the nerves are modulated by electrical impulses rather than chemical deactivation. SCS modulates the autonomic innervation of the heart by reducing stellate ganglia activity, 87 increasing vagal tone, 88 altering intrinsic cardiac neuron activity, 89 and modifying sympathetic nerve sprouting in the myocardium.…”

Section: Neuraxial Modulation To Reduce Risk Of Scdmentioning

confidence: 99%

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Cardiac Innervation and the Autonomic Nervous System in Sudden Cardiac Death

Huang¹,

Boyle²,

Vaseghi³

2017

Cardiac Electrophysiology Clinics

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Summary Neural remodeling in the autonomic nervous system contributes significantly to sudden cardiac death. The fabric of cardiac excitability and propagation are controlled by autonomic innervation. Heart disease predisposes to malignant ventricular arrhythmias by causing neural remodeling at the level of the myocardium, the intrinsic cardiac ganglia, extra-cardiac intrathoracic sympathetic ganglia, extra-thoracic ganglia, spinal cord, and the brainstem, as well as the higher centers and the cortex. Therapeutic strategies at each of these levels aim to restore the balance between the sympathetic and parasympathetic branches. Understanding this complex neural network will provide further important therapeutic insights into the treatment of sudden cardiac death.

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“…The autonomic nervous system regulates several critical physiologic processes, and its role in the genesis of cardiac arrhythmias is increasingly recognized. 112,113 The paravertebral autonomic ganglia supply sympathetic innervation and the ganglionated plexi (GP) on the extrinsic surface of the heart supply predominantly parasympathetic innervation, although sympathetic components are also present. Modulation of the autonomic nervous system may be a target for the management of multiple disorders that cardiologists face on a regular basis, including AF, ventricular tachycardia, heart failure, and orthostatic hypotension syndromes.…”

Section: Novel Targets For Catheter Ablationmentioning

confidence: 99%