Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, PR China; Cardiovascular Research Institute of Wuhan University, Wuhan, PR China.
Med Hypotheses. 2013 Nov;81(5):905-7. doi: 10.1016/j.mehy.2013.08.008. Epub 2013 Aug 22.
An autonomic imbalance, i.e., increased sympathetic tone and/or decreased parasympathetic tone is a critical characteristic of heart failure, which is associated with progressive ventricular remodeling, ventricular arrhythmia generation and disease progression. Increasing cardiac parasympathetic tone by vagus nerve stimulation has been shown to significantly improve heart failure symptoms, hemodynamics, left ventricular function and quality of life. However, cervical surgery is needed to position vagal stimulation electrode and vagus nerve stimulation may also cause some undesired side effects. Our recent studies showed that ablation of the main atrial ganglionated plexi (GP) facilitated the occurrence of ventricular arrhythmias in acute myocardial ischemic heart while low-intensity atrial GP stimulation inhibited the occurrence of ventricular arrhythmias during acute myocardial ischemia and ischemia reperfusion. Based on these results, we hypothesize that atrial GP stimulation may ameliorate autonomic dysfunction in heart failure, inhibit heart failure progression and improve heart failure prognosis.
自主神经失衡，即交感神经张力增加和/或副交感神经张力降低，是心力衰竭的一个关键特征，与进行性心室重构、室性心律失常发生和疾病进展有关。通过迷走神经刺激增加心脏副交感神经张力已被证明可显著改善心力衰竭症状、血液动力学、左心室功能和生活质量。然而，需要进行颈部手术来定位迷走神经刺激电极，并且迷走神经刺激也可能引起一些不良的副作用。我们最近的研究表明，消融主要心房神经节丛 (GP) 可促进急性心肌缺血性心脏中室性心律失常的发生，而低强度心房 GP 刺激可抑制急性心肌缺血和缺血再灌注期间室性心律失常的发生。基于这些结果，我们假设心房 GP 刺激可能改善心力衰竭中的自主神经功能障碍，抑制心力衰竭进展并改善心力衰竭预后。
