TY - JOUR
T1 - Autonomic Dysfunction and Neurohormonal Disorders in Atrial Fibrillation
AU - Pfenniger, Anna
AU - Geist, Gail Elizabeth
AU - Arora, Rishi
N1 - Funding Information:
Dr. Arora is supported by NIH grants R01 HL093490 and R01 HL140061; the American Heart Association (AHA) Strategically Focused Research Networks AF Center grant; NIH Center for Accelerated Innovations at Cleveland Clinic (NCAI-CC). R. Arora: Ownership interest, Rhythm Therapeutics, Inc. Other authors have no conflicts related to this study. • The beneficial effects of risk factor modification for atrial fibrillation, such as weight loss and treatment of sleep apnea, are partly mediated by their effect on the autonomic nervous system. • Pulmonary vein isolation by catheter ablation causes partial autonomic denervation by ablation of the ganglionated plexi, likely contributing to the efficacy of ablation. • Strategies directly targeting the autonomic nervous system, either by denervation or by neuromodulation, are promising avenues for the treatment of atrial fibrillation.
Funding Information:
Dr. Arora is supported by NIH grants R01 HL093490 and R01 HL140061; the American Heart Association (AHA) Strategically Focused Research Networks AF Center grant; NIH Center for Accelerated Innovations at Cleveland Clinic (NCAI-CC).
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/3
Y1 - 2021/3
N2 - Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia and eludes an efficacious cure despite an increasing prevalence and a significant association with morbidity and mortality. In addition to an array of clinical sequelae, the origins and propagation of AF are multifactorial. In recent years, the contribution from the autonomic nervous system has been an area of particular interest. This review highlights the relevant physiology of autonomic and neurohormonal contributions to AF origin and maintenance, the current state of the literature on targeted therapies, and the path forward for clinical interventions.
AB - Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia and eludes an efficacious cure despite an increasing prevalence and a significant association with morbidity and mortality. In addition to an array of clinical sequelae, the origins and propagation of AF are multifactorial. In recent years, the contribution from the autonomic nervous system has been an area of particular interest. This review highlights the relevant physiology of autonomic and neurohormonal contributions to AF origin and maintenance, the current state of the literature on targeted therapies, and the path forward for clinical interventions.
KW - Atrial fibrillation
KW - Autonomic modulation
KW - Autonomic nervous system
KW - Neurohormonal
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U2 - 10.1016/j.ccep.2020.11.012
DO - 10.1016/j.ccep.2020.11.012
M3 - Review article
C2 - 33516396
AN - SCOPUS:85099543712
SN - 1877-9182
VL - 13
SP - 183
EP - 190
JO - Cardiac Electrophysiology Clinics
JF - Cardiac Electrophysiology Clinics
IS - 1
ER -