The role of autonomic nervous system on atrial fibrillation and its pharmacological modification

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There have been reported that electrophysiological(electrical remodeling) and structural changes(structural remodeling) caused by rapid atrial firing play an important role in the development and maintenance of atrial fibrillation. Recent evidence suggests that autonomic nervous system may also contribute to the mechanisms of atrial fibrillation. However, the relationship between atrial fibrillation and the autonomic nervous system changes is yet elucidated.In this study, the authors evaluated the changes of autonomic nervous system as a substrate of atrial fibrillation by using canine atrial tachypacing model. Prolonged atrial tachypacing caused atrial electrical remodeling and atrial fibrillation promotion accompanying by increased atrial autonomic nerve sprouting, especially sympathetic nerve sprouting. Carvedilol, an alpha and beta blocker, significantly attenuated atrial remodeling and atrial fibrillation promotion, suggesting that autonomic nervous system may play an important role on atrial remodeling and its pharmacological modification could be a possible approach to prevent atrial fibrillation.