房颤的神经调节治疗。
Neuromodulation therapy for atrial fibrillation.
机构信息
Cardiac Electrophysiology Section, Duke Heart Center and Department of Medicine, Duke University Medical Center, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Department of Anesthesiology, Duke University, Durham, North Carolina.
出版信息
Heart Rhythm. 2023 Jan;20(1):100-111. doi: 10.1016/j.hrthm.2022.08.011. Epub 2022 Aug 18.
Abstract
Atrial fibrillation has a multifactorial pathophysiology influenced by cardiac autonomic innervation. Both sympathetic and parasympathetic influences are profibrillatory. Innovative therapies targeting the neurocardiac axis include catheter ablation or pharmacologic suppression of ganglionated plexi, renal sympathetic denervation, low-level vagal stimulation, and stellate ganglion blockade. To date, these therapies have variable efficacy. As our understanding of atrial fibrillation and the cardiac nervous system expands, our approach to therapeutic neuromodulation will continue evolving for the benefit of those with AF.
摘要
心房颤动的病理生理学具有多因素特性，受心脏自主神经支配的影响。交感神经和副交感神经的影响都是致心律失常的。针对心神经轴的创新治疗方法包括导管消融或神经节丛的药物抑制、肾交感神经去神经支配、低水平迷走神经刺激和星状神经节阻滞。迄今为止，这些治疗方法的疗效各不相同。随着我们对心房颤动和心脏神经系统的理解不断深入，我们对治疗性神经调节的方法也将不断发展，以使患有心房颤动的患者受益。
相似文献
1
Neuromodulation therapy for atrial fibrillation.
Heart Rhythm. 2023 Jan;20(1):100-111. doi: 10.1016/j.hrthm.2022.08.011. Epub 2022 Aug 18.
2
Is the Atrial Neural Plexis a Therapeutic Target in Atrial Fibrillation?
Methodist Debakey Cardiovasc J. 2015 Apr-Jun;11(2):82-6. doi: 10.14797/mdcj-11-2-82.
3
Ganglionated plexi as neuromodulation targets for atrial fibrillation.
J Cardiovasc Electrophysiol. 2017 Dec;28(12):1485-1491. doi: 10.1111/jce.13319. Epub 2017 Sep 8.
4
Atrial autonomic innervation: a target for interventional antiarrhythmic therapy?
J Am Coll Cardiol. 2014 Jan 28;63(3):215-24. doi: 10.1016/j.jacc.2013.09.020. Epub 2013 Oct 16.
5
Neural Mechanisms and Therapeutic Opportunities for Atrial Fibrillation.
Methodist Debakey Cardiovasc J. 2021 Apr 5;17(1):43-47. doi: 10.14797/FVDN2224. Epub 2021 Mar 25.
6
Neuromodulation for cardiac arrhythmia.
Heart Rhythm. 2016 Feb;13(2):584-92. doi: 10.1016/j.hrthm.2015.10.001. Epub 2015 Oct 9.
7
The cardiac autonomic nervous system: A target for modulation of atrial fibrillation.
Clin Cardiol. 2019 Jun;42(6):644-652. doi: 10.1002/clc.23190. Epub 2019 May 6.
8
Heart rate variability in atrial fibrillation: The balance between sympathetic and parasympathetic nervous system.
Eur J Clin Invest. 2019 Nov;49(11):e13174. doi: 10.1111/eci.13174.
9
Neuroscientific therapies for atrial fibrillation.
Cardiovasc Res. 2021 Jun 16;117(7):1732-1745. doi: 10.1093/cvr/cvab172.
10
Vagal denervation and reinnervation after ablation of ganglionated plexi.
J Thorac Cardiovasc Surg. 2010 Feb;139(2):444-52. doi: 10.1016/j.jtcvs.2009.04.056. Epub 2009 Sep 9.
引用本文的文献
1
Heart rate variability in patients with atrial fibrillation of sinus rhythm or atrial fibrillation: chaos or merit?
Ann Med. 2025 Dec;57(1):2478474. doi: 10.1080/07853890.2025.2478474. Epub 2025 Mar 13.
2
"Pharmacological" analysis of atrial fibrillation maintenance mechanism: reentry, wavelets, or focal?
Front Cardiovasc Med. 2025 Jan 24;12:1447542. doi: 10.3389/fcvm.2025.1447542. eCollection 2025.
3
Integrated Management of Persistent Atrial Fibrillation.
Biomedicines. 2025 Jan 2;13(1):91. doi: 10.3390/biomedicines13010091.
4
Catheter Ablation in Atrial Fibrillation: Recent Advances.
J Clin Med. 2024 Dec 17;13(24):7700. doi: 10.3390/jcm13247700.
5
Emerging Role of Renal Sympathetic Denervation as an Adjunct Therapy to Atrial Fibrillation Ablation.
Rev Cardiovasc Med. 2024 Mar 28;25(4):122. doi: 10.31083/j.rcm2504122. eCollection 2024 Apr.
6
Development of neuromodulation for atrial fibrillation: a narrative review.
J Thorac Dis. 2024 May 31;16(5):3472-3483. doi: 10.21037/jtd-23-1981. Epub 2024 May 20.
7
Circulating neuropeptide Y as a biomarker in postoperative atrial fibrillation cases administered off-pump coronary bypass Graft surgery.
Heliyon. 2024 May 14;10(10):e31251. doi: 10.1016/j.heliyon.2024.e31251. eCollection 2024 May 30.
8
Obesity effect on newly diagnosed and recurrent post-ablation atrial fibrillation: a systematic review and meta-analysis.
J Endocrinol Invest. 2024 May;47(5):1051-1066. doi: 10.1007/s40618-023-02225-x. Epub 2023 Nov 14.
9
Device therapy for patients with atrial fibrillation and heart failure with preserved ejection fraction.
Heart Fail Rev. 2024 Mar;29(2):417-430. doi: 10.1007/s10741-023-10366-7. Epub 2023 Nov 8.
10
Cardioneuroablation Using Epicardial Pulsed Field Ablation for the Treatment of Atrial Fibrillation.
J Cardiovasc Dev Dis. 2023 May 29;10(6):238. doi: 10.3390/jcdd10060238.
本文引用的文献
1
Higher heart rate variability as a predictor of atrial fibrillation in patients with hypertension.
Sci Rep. 2022 Mar 8;12(1):3702. doi: 10.1038/s41598-022-07783-3.
2
Temporary Spinal Cord Stimulation to Prevent Postcardiac Surgery Atrial Fibrillation: 30-Day Safety and Efficacy Outcomes.
J Am Coll Cardiol. 2022 Feb 22;79(7):754-756. doi: 10.1016/j.jacc.2021.08.078.
3
Ectopy-triggering ganglionated plexuses ablation to prevent atrial fibrillation: GANGLIA-AF study.
Heart Rhythm. 2022 Apr;19(4):516-524. doi: 10.1016/j.hrthm.2021.12.010. Epub 2021 Dec 13.
4
Design and Rationale of a Phase 2 Study of NeurOtoxin (Botulinum Toxin Type A) for the PreVention of Post-Operative Atrial Fibrillation - The NOVA Study.
Am Heart J. 2022 Mar;245:51-59. doi: 10.1016/j.ahj.2021.10.114. Epub 2021 Oct 20.
5
Anatomy and Physiology of Intrinsic Cardiac Autonomic Nervous System: Da Vinci Anatomy Card #2.
JACC Case Rep. 2021 Apr 21;3(4):625-629. doi: 10.1016/j.jaccas.2021.02.018. eCollection 2021 Apr.
6
The Heart's Little Brain: Shedding New Light and CLARITY on the "Black Box".
Circ Res. 2021 Apr 30;128(9):1297-1299. doi: 10.1161/CIRCRESAHA.121.319148. Epub 2021 Apr 29.
7
Innervation and Neuronal Control of the Mammalian Sinoatrial Node a Comprehensive Atlas.
Circ Res. 2021 Apr 30;128(9):1279-1296. doi: 10.1161/CIRCRESAHA.120.318458. Epub 2021 Feb 25.
8
Renal Sympathetic Denervation as Upstream Therapy During Atrial Fibrillation Ablation: Pilot HFIB Studies and Meta-Analysis.
JACC Clin Electrophysiol. 2021 Jan;7(1):109-123. doi: 10.1016/j.jacep.2020.08.013. Epub 2020 Oct 28.
9
Calcium-Induced Autonomic Denervation in Patients With Post-Operative Atrial Fibrillation.
J Am Coll Cardiol. 2021 Jan 5;77(1):57-67. doi: 10.1016/j.jacc.2020.10.049.
10
Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation: Results of CONVERGE Clinical Trial.
Circ Arrhythm Electrophysiol. 2020 Dec;13(12):e009288. doi: 10.1161/CIRCEP.120.009288. Epub 2020 Nov 13.
Zotero 插件