UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
Auton Neurosci. 2022 Dec;243:103037. doi: 10.1016/j.autneu.2022.103037. Epub 2022 Sep 24.
The autonomic nervous system functions in a fine-tuned manner to dynamically modulate cardiac function during normal physiological state. Autonomic dysregulation in cardiac disease states such as myocardial infarction and heart failure alters this fine balance, which in turn promotes disease progression and arrhythmogenesis. Neuromodulatory interventions that aim to restore this balance at distinct levels of the cardiac neuraxis thus have been shown to be effective in the treatment of arrhythmias. This review first describes the anatomy of the cardiac autonomic nervous system and the pathological changes that occur with neural remodeling in the setting of scar and cardiomyopathy, followed by therapeutic interventions for neuraxial modulation of arrhythmias such as atrial fibrillation and ventricular tachyarrhythmias.
自主神经系统以精细调节的方式在正常生理状态下动态调节心脏功能。在心肌梗死和心力衰竭等心脏疾病状态下，自主神经调节失调会改变这种微妙的平衡，进而促进疾病进展和心律失常发生。因此，旨在在心脏神经轴的不同水平上恢复这种平衡的神经调节干预措施已被证明可有效治疗心律失常。本综述首先描述了心脏自主神经系统的解剖结构以及在瘢痕和心肌病背景下神经重塑时发生的病理变化，然后介绍了用于治疗心房颤动和室性心动过速等心律失常的神经轴调制治疗干预措施。
