The Role of the Autonomic Nervous System as Both “Trigger and “Substrate” in Atrial Fibrillation

Varun Malik; Dominik Linz; Prashanthan Sanders

doi:10.1016/j.ccep.2023.08.003

The Role of the Autonomic Nervous System as Both “Trigger and “Substrate” in Atrial Fibrillation

Varun Malik, Dominik Linz, Prashanthan Sanders^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

KEYWORDS
Atrial fibrillation Autonomic nervous system Efferent autonomic nerves
Afferent autonomic nerves Baroreceptors Atrial remodeling Autonomic remodeling
KEY POINTS
There are several interacting mechanisms that serve either as (1) trigger or (2) substrate (maintain)
atrial fibrillation (AF).
Efferent autonomic activity is well-known to trigger AF, even in structurally normal hearts.
AF is associated with autonomic atrial neural remodeling (sympathetic and parasympathetic hyperinnervation as well as nerve growth). However, efferent autonomic tone does not seem to influence
AF progression.
There is emerging evidence of afferent or regulatory autonomic nervous system dysfunction in patients with AF. Reversible dysfunction of volume-regulating reflexes occurs during AF with persisting abnormalities during sinus rhythm.
These studies could provide a mechanistic link for the progression of AF.

Original language	English
Pages (from-to)	271-280
Number of pages	10
Journal	Cardiac Electrophysiology Clinics
Volume	16
Issue number	3
Early online date	19 Sept 2023
DOIs	https://doi.org/10.1016/j.ccep.2023.08.003
Publication status	Published - Sept 2024

Keywords

Afferent autonomic nerves
Atrial fibrillation
Atrial remodeling
Autonomic nervous system
Autonomic remodeling
Baroreceptors
Efferent autonomic nerves

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10.1016/j.ccep.2023.08.003

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@article{32b858b234a042df8779f6d1099ddbac,

title = "The Role of the Autonomic Nervous System as Both “Trigger and “Substrate” in Atrial Fibrillation",

abstract = "KEYWORDS Atrial fibrillation Autonomic nervous system Efferent autonomic nerves Afferent autonomic nerves Baroreceptors Atrial remodeling Autonomic remodelingKEY POINTS There are several interacting mechanisms that serve either as (1) trigger or (2) substrate (maintain)atrial fibrillation (AF). Efferent autonomic activity is well-known to trigger AF, even in structurally normal hearts. AF is associated with autonomic atrial neural remodeling (sympathetic and parasympathetic hyperinnervation as well as nerve growth). However, efferent autonomic tone does not seem to influenceAF progression. There is emerging evidence of afferent or regulatory autonomic nervous system dysfunction in patients with AF. Reversible dysfunction of volume-regulating reflexes occurs during AF with persisting abnormalities during sinus rhythm. These studies could provide a mechanistic link for the progression of AF.",

keywords = "Afferent autonomic nerves, Atrial fibrillation, Atrial remodeling, Autonomic nervous system, Autonomic remodeling, Baroreceptors, Efferent autonomic nerves",

author = "Varun Malik and Dominik Linz and Prashanthan Sanders",

note = "Funding Information: Funding Statement: Dr V. Malik was supported by an Australian Postgraduate Award Scholarship from the University of Adelaide, Australia . Dr P. Sanders is supported by an Investigator Grant from the National Health and Medical Research Council of Australia.",

year = "2024",

month = sep,

doi = "10.1016/j.ccep.2023.08.003",

language = "English",

volume = "16",

pages = "271--280",

journal = "Cardiac Electrophysiology Clinics",

issn = "1877-9182",

publisher = "W.B. Saunders Co.",

number = "3",

}

TY - JOUR

T1 - The Role of the Autonomic Nervous System as Both “Trigger and “Substrate” in Atrial Fibrillation

AU - Malik, Varun

AU - Linz, Dominik

AU - Sanders, Prashanthan

N1 - Funding Information: Funding Statement: Dr V. Malik was supported by an Australian Postgraduate Award Scholarship from the University of Adelaide, Australia . Dr P. Sanders is supported by an Investigator Grant from the National Health and Medical Research Council of Australia.

PY - 2024/9

Y1 - 2024/9

N2 - KEYWORDS Atrial fibrillation Autonomic nervous system Efferent autonomic nerves Afferent autonomic nerves Baroreceptors Atrial remodeling Autonomic remodelingKEY POINTS There are several interacting mechanisms that serve either as (1) trigger or (2) substrate (maintain)atrial fibrillation (AF). Efferent autonomic activity is well-known to trigger AF, even in structurally normal hearts. AF is associated with autonomic atrial neural remodeling (sympathetic and parasympathetic hyperinnervation as well as nerve growth). However, efferent autonomic tone does not seem to influenceAF progression. There is emerging evidence of afferent or regulatory autonomic nervous system dysfunction in patients with AF. Reversible dysfunction of volume-regulating reflexes occurs during AF with persisting abnormalities during sinus rhythm. These studies could provide a mechanistic link for the progression of AF.

AB - KEYWORDS Atrial fibrillation Autonomic nervous system Efferent autonomic nerves Afferent autonomic nerves Baroreceptors Atrial remodeling Autonomic remodelingKEY POINTS There are several interacting mechanisms that serve either as (1) trigger or (2) substrate (maintain)atrial fibrillation (AF). Efferent autonomic activity is well-known to trigger AF, even in structurally normal hearts. AF is associated with autonomic atrial neural remodeling (sympathetic and parasympathetic hyperinnervation as well as nerve growth). However, efferent autonomic tone does not seem to influenceAF progression. There is emerging evidence of afferent or regulatory autonomic nervous system dysfunction in patients with AF. Reversible dysfunction of volume-regulating reflexes occurs during AF with persisting abnormalities during sinus rhythm. These studies could provide a mechanistic link for the progression of AF.

KW - Afferent autonomic nerves

KW - Atrial fibrillation

KW - Atrial remodeling

KW - Autonomic nervous system

KW - Autonomic remodeling

KW - Baroreceptors

KW - Efferent autonomic nerves

U2 - 10.1016/j.ccep.2023.08.003

DO - 10.1016/j.ccep.2023.08.003

M3 - (Systematic) Review article

SN - 1877-9182

VL - 16

SP - 271

EP - 280

JO - Cardiac Electrophysiology Clinics

JF - Cardiac Electrophysiology Clinics

IS - 3

ER -

The Role of the Autonomic Nervous System as Both “Trigger and “Substrate” in Atrial Fibrillation

Abstract

Keywords

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