Vagal response in cryoballoon ablation of atrial fibrillation and autonomic nervous system: Utility of epicardial adipose tissue location

The role of epicardial adipose tissue (EAT) in the pathogenesis and prognosis of cardiovascular diseases has been actively discussed. This review provides information regarding the main mechanisms by which EAT influences the pathophysiology of rhythm disturbances, such as atrial fibrillation and ventricular arrhythmias, as well as their relationship with chronic heart failure. The pathogenesis of cardiac arrhythmias is exceedingly complex. As such, the mechanism by which EAT influences arrhythmias and heart failure can vary according to the anatomy and type of arrhythmia, one of which involves the autonomic nervous system (ANS). Some studies have shown a good treatment effects by targeting EAT in atrial fibrillation, whereas others have found that EAT volume can be used to predict the efficacy of radiofrequency ablation, a method for treating atrial fibrillation and ventricular arrhythmias. However, no standards have yet been established for the use of EAT visualisation. Fundamental, translational and clinical research are needed to study the role of EAT and ANS in the pathogenesis of cardiovascular diseases.Received 15 March 2021. Revised 25 April 2021. Accepted 26 April 2021.Funding: The work is supported by a grant of the Russian Science Foundation (project No. 17-75-20118).Conflict of interest: The authors declare no conflicts of interests.Contribution of the authors Conception and study design: D.V. Losik, N.A. Nikitin, S.M. Minin, A.B. Romanov, A.M. Chernyavskiy Drafting the article: D.V. Losik, I.L. Mikheenko, E.V. Fisher, N.A. Nikitin Critical revision of the article: D.V. Losik, I.L. Mikheenko, E.V. Fisher, N.A. Nikitin Final approval of the version to be published: D.V. Losik, N.A. Nikitin, S.M. Minin, E.V. Fisher, I.L. Mikheenko, A.M. Chernyavskiy, A.B. Romanov

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Letter to the editor: The effect of autonomic nervous system on the association between epicardial adipose tissue and cognitive function

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00018.2015 ◽

2015 ◽

Vol 308 (7) ◽

pp. H778-H778 ◽

Cited By ~ 1

Author(s):

Seref Ulucan ◽

Zeynettin Kaya ◽

Ahmet Keser ◽

Huseyin Katlandur

Keyword(s):

Nervous System ◽

Adipose Tissue ◽

Autonomic Nervous System ◽

Cognitive Function ◽

Epicardial Adipose Tissue ◽

Autonomic Nervous ◽

Letter To The Editor

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Role of the Autonomic Nervous System in the Creation of Substrate for Atrial Fibrillation

Journal of Atrial Fibrillation ◽

10.4022/jafib.v1i4.512 ◽

2008 ◽

Vol 1 (4) ◽

Author(s):

Rishi Arora ◽

Alan H. Kadish

Keyword(s):

Atrial Fibrillation ◽

Nervous System ◽

Autonomic Nervous System ◽

Autonomic Nervous ◽

The Creation

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Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction

Journal of Clinical Medicine ◽

10.3390/jcm9051481 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1481 ◽

Cited By ~ 1

Author(s):

Audrey Sagnard ◽

Charles Guenancia ◽

Basile Mouhat ◽

Maud Maza ◽

Marie Fichot ◽

...

Keyword(s):

Myocardial Infarction ◽

Atrial Fibrillation ◽

Acute Myocardial Infarction ◽

Nervous System ◽

Autonomic Nervous System ◽

Sinus Rhythm ◽

Left Ventricular Ejection ◽

Holter Ecg ◽

Autonomic Nervous ◽

New Onset

Background: Atrial fibrillation (AF) is common after acute myocardial infarction (AMI) and associated with in-hospital and long-term mortality. However, the pathophysiology of AF in AMI is poorly understood. Heart rate variability (HRV), measured by Holter-ECG, reflects cardiovascular response to the autonomic nervous system and altered (reduced or enhanced) HRV may have a major role in the onset of AF in AMI patients. Objective: We investigated the relationship between autonomic dysregulation and new-onset AF during AMI. Methods: As part of the RICO survey, all consecutive patients hospitalized for AMI at Dijon (France) university hospital between June 2001 and November 2014 were analyzed by Holter-ECG <24 h following admission. HRV was measured using temporal and spectral analysis. Results: Among the 2040 included patients, 168 (8.2%) developed AF during AMI. Compared to the sinus-rhythm (SR) group, AF patients were older, had more frequent hypertension and lower left ventricular ejection fraction LVEF. On the Holter parameters, AF patients had higher pNN50 values (11% vs. 4%, p < 0.001) and median LH/HF ratio, a reflection of sympathovagal balance, was significantly lower in the AF group (0.88 vs 2.75 p < 0.001). The optimal LF/HF cut-off for AF prediction was 1.735. In multivariate analyses, low LF/HF <1.735 (OR(95%CI) = 3.377 (2.047–5.572)) was strongly associated with AF, ahead of age (OR(95%CI) = 1.04(1.01–1.06)), mean sinus-rhythm rate (OR(95%CI) = 1.03(1.02–1.05)) and log NT-proBNP (OR(95%CI) = 1.38(1.01–1.90). Conclusion: Our study strongly suggests that new-onset AF in AMI mainly occurs in a dysregulated autonomic nervous system, as suggested by low LF/HF, and higher PNN50 and RMSSD values.

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