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

已有报道指出，心房快速放电引起的电生理（电重构）和结构改变（结构重构）在心房颤动的发生和维持中起着重要作用。最近的证据表明，自主神经系统也可能参与心房颤动的机制。然而，心房颤动与自主神经系统变化之间的关系尚不清楚。在本研究中，作者通过犬心房速搏模型评估了自主神经系统作为心房颤动的底物的变化。房性心动过速延长引起心房电重构和房颤促进，并伴有心房自主神经芽出增加，尤其是交感神经芽出增加。卡维地洛是一种α和β阻滞剂，可显著减弱心房重构和促进心房颤动，提示自主神经系统可能在心房重构中起重要作用，其药理修饰可能是预防心房颤动的一种可能途径。

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.