It is increasingly recognized that the autonomic nervous system (ANS) is
a major contributor in many cardiac arrhythmias. Cardiac ANS can be
divided into extrinsic and intrinsic parts according to the course of
nerve fibers and localization of ganglia and neuron bodies. Although the
role of extrinsic part has historically gained more attention, the
intrinsic cardiac ANS may affect cardiac function independently as well
as influence the effects of the extrinsic nerves. Catheter based
modulation of the intrinsic cardiac ANS is emerging as a novel therapy
for management of patients with brady and tachy arrhythmias resulting
from hyperactive vagal activation. However, distribution of intrinsic
cardiac nerve plexus in the human heart and the functional properties of
intrinsic cardiac neural elements remain insufficiently understood. The
present review aims to bring the clinical and anatomical elements of the
ICANS together, by reviewing neuroanatomical terminologies and
physiological functions, in order to guide the clinical
electrophysiologist in the catheter lab, and to serve as a reference for
further research.
Role of the Autonomic Nervous System in Modulating Cardiac Arrhythmias
