New concepts in atrial fibrillation: neural mechanisms and calcium dynamics.
Atrial fibrillation (AF) is a complex arrhythmia with multiple possible mechanisms. It requires a trigger for initiation and a favorable substrate for maintenance. Pulmonary vein myocardial sleeves have the potential to generate spontaneous activity, and this arrhythmogenic activity is surfaced by modulation of intracellular calcium dynamics. Direct autonomic nerve recordings in canine models show that simultaneous sympathovagal discharges are the most common triggers of paroxysmal atrial tachycardia and paroxysmal AF. Autonomic modulation as a potential therapeutic strategy has been targeted clinically and experimentally, but its effectiveness as an adjunctive therapeutic modality to catheter ablation of AF has been inconsistent. Further studies are warranted before application can be widely implied for therapies of clinical AF.
Chou
Chung-Chuan
CC
The Second Section of Cardiology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei 10591, Taiwan. 2867@adm.cgmh.org.tw
Chen
Peng-Sheng
PS
D000818:Animals; D001281:Atrial Fibrillation / Q000378:metabolism* / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002118:Calcium / Q000378:metabolism*; D015220:Calcium Channels / Q000378:metabolism; D006325:Heart Atria / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D011667:Pulmonary Veins / Q000294:innervation; D015398:Signal Transduction
D015220:Calcium Channels; D002118:Calcium