Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go
The nuance of autonomic cardiac control has been studied for more than 400 years, yet little is understood. This review aimed to provide a comprehensive overview of the current understanding, clinical implications, and ongoing studies of cardiac sympathetic modulation and its anti-ventricular arrhyt...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/5/786 |
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| author | Wei-Hsin Chung Yen-Nien Lin Mei-Yao Wu Kuan-Cheng Chang |
| author_facet | Wei-Hsin Chung Yen-Nien Lin Mei-Yao Wu Kuan-Cheng Chang |
| author_sort | Wei-Hsin Chung |
| collection | DOAJ |
| description | The nuance of autonomic cardiac control has been studied for more than 400 years, yet little is understood. This review aimed to provide a comprehensive overview of the current understanding, clinical implications, and ongoing studies of cardiac sympathetic modulation and its anti-ventricular arrhythmias’ therapeutic potential. Molecular-level studies and clinical studies were reviewed to elucidate the gaps in knowledge and the possible future directions for these strategies to be translated into the clinical setting. Imbalanced sympathoexcitation and parasympathetic withdrawal destabilize cardiac electrophysiology and confer the development of ventricular arrhythmias. Therefore, the current strategy for rebalancing the autonomic system includes attenuating sympathoexcitation and increasing vagal tone. Multilevel targets of the cardiac neuraxis exist, and some have emerged as promising antiarrhythmic strategies. These interventions include pharmacological blockade, permanent cardiac sympathetic denervation, temporal cardiac sympathetic denervation, etc. The gold standard approach, however, has not been known. Although neuromodulatory strategies have been shown to be highly effective in several acute animal studies with very promising results, the individual and interspecies variation between human autonomic systems limits the progress in this young field. There is, however, still much room to refine the current neuromodulation therapy to meet the unmet need for life-threatening ventricular arrhythmias. |
| first_indexed | 2024-03-11T03:35:44Z |
| format | Article |
| id | doaj.art-a6988f351f304828a01501ccd3b8b131 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T03:35:44Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-a6988f351f304828a01501ccd3b8b1312023-11-18T02:04:07ZengMDPI AGJournal of Personalized Medicine2075-44262023-05-0113578610.3390/jpm13050786Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We GoWei-Hsin Chung0Yen-Nien Lin1Mei-Yao Wu2Kuan-Cheng Chang3Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, TaiwanDivision of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, TaiwanSchool of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 404333, TaiwanDivision of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, TaiwanThe nuance of autonomic cardiac control has been studied for more than 400 years, yet little is understood. This review aimed to provide a comprehensive overview of the current understanding, clinical implications, and ongoing studies of cardiac sympathetic modulation and its anti-ventricular arrhythmias’ therapeutic potential. Molecular-level studies and clinical studies were reviewed to elucidate the gaps in knowledge and the possible future directions for these strategies to be translated into the clinical setting. Imbalanced sympathoexcitation and parasympathetic withdrawal destabilize cardiac electrophysiology and confer the development of ventricular arrhythmias. Therefore, the current strategy for rebalancing the autonomic system includes attenuating sympathoexcitation and increasing vagal tone. Multilevel targets of the cardiac neuraxis exist, and some have emerged as promising antiarrhythmic strategies. These interventions include pharmacological blockade, permanent cardiac sympathetic denervation, temporal cardiac sympathetic denervation, etc. The gold standard approach, however, has not been known. Although neuromodulatory strategies have been shown to be highly effective in several acute animal studies with very promising results, the individual and interspecies variation between human autonomic systems limits the progress in this young field. There is, however, still much room to refine the current neuromodulation therapy to meet the unmet need for life-threatening ventricular arrhythmias.https://www.mdpi.com/2075-4426/13/5/786sympathetic modulationarrhythmias |
| spellingShingle | Wei-Hsin Chung Yen-Nien Lin Mei-Yao Wu Kuan-Cheng Chang Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go Journal of Personalized Medicine sympathetic modulation arrhythmias |
| title | Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go |
| title_full | Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go |
| title_fullStr | Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go |
| title_full_unstemmed | Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go |
| title_short | Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go |
| title_sort | sympathetic modulation in cardiac arrhythmias where we stand and where we go |
| topic | sympathetic modulation arrhythmias |
| url | https://www.mdpi.com/2075-4426/13/5/786 |
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