■心房颤动(AF)是一种常见的临床心律失常,具有很高的残疾和死亡率。自主神经系统(ANS)在房颤的发生和持续中起着至关重要的作用,并可导致心房结构的电生理变化和改变。动物模型和临床发现均表明,心脏ANS内的副交感神经和交感神经活动可引起心房重构和AF。心脏自主神经的重塑是促进AF的重要结构基础。鉴于常规药物和心房消融技术治疗房颤所面临的挑战,房颤的自主神经干预策略日益受到重视。目前的研究表明,通过调节ANS的活性可以显着降低AF发作的频率和严重程度。ANS神经调节有望为房颤患者带来更有效和个性化的治疗选择。这篇综述的目的是通过回顾治疗房颤的神经调节方法的临床前和临床研究,为未来的相关研究提供更广阔的视野。寻找治疗房颤的相关方法,以及确定当前相关研究显示的优势和劣势,并为研究人员提供了最新的神经学治疗房颤的更广泛的概述。
■对PubMed,万方数据,和谷歌学者,包括直到2023年11月发表的所有相关研究。
■在这篇评论中,我们深入研究心脏自主神经的神经支配,ANS在AF开发和维护中的作用,以及目前用于房颤治疗的神经调节方法。这些方法包括星状神经节(SG)切除或消融,迷走神经刺激(VNS),胸皮下神经刺激(ScNS),去肾神经(RDN)治疗,神经节丛(GP)消融,和心外膜肉毒毒素或CaCl2注射。越来越多的研究表明,神经调节方法治疗房颤具有广阔的前景。
■ANS通过心脏自主神经重塑在房颤的发展和维持中起着至关重要的作用。调节ANS活性可以显著降低AF频率和严重程度,提供更多个性化的治疗选择。目前对房颤自主神经干预的研究显示了更有效和个性化治疗的前景。
UNASSIGNED: Atrial fibrillation (AF) is a prevalent clinical arrhythmia with a high incidence of disability and mortality. Autonomic nervous system (ANS) plays a crucial role in the onset and persistence of AF, and can lead to electrophysiological changes and alterations in atrial structure. Both animal models and clinical findings suggest that parasympathetic and sympathetic activity within the cardiac ANS could induce atrial remodeling and AF. Remodeling of the cardiac autonomic nerves is a significant structural basis for promoting AF. Given the challenges faced by conventional pharmacological and atrial ablation techniques in the treatment of AF, increasing attention has been paid to autonomic intervention strategies for AF. Current research has demonstrated that the frequency and severity of AF episodes can be significantly reduced by modulating the activity of ANS. ANS neuromodulation is expected to lead more effective and personalized treatment options for patients with AF. The objective of this review is to provide a broader perspective for future related studies by reviewing preclinical and clinical studies of neuromodulation methods for the treatment of AF, searching for relevant approaches to treat AF, as well as identifying the strengths and weaknesses demonstrated by current relevant studies, and providing researchers with a broader overview of the latest neurological treatments for AF.
UNASSIGNED: A narrative review was conducted on the literature on PubMed, WanFang data, and Google Scholar, including all relevant studies published until November 2023.
UNASSIGNED: In this review, we delve into the innervation of cardiac autonomic nerves, the role of the ANS in the development and maintenance of AF, and the current neuromodulation methods for AF treatment. These methods include stellate ganglion (SG) resection or ablation, vagus nerve stimulation (VNS), thoracic subcutaneous nerve stimulation (ScNS), renal denervation (RDN) therapy, ganglionated plexus (GP) ablation, and epicardial botulinum toxin or CaCl2 injection. More and more research suggests that neuromodulation methods for the treatment of AF have broad prospects.
UNASSIGNED: ANS plays a crucial role in AF development and maintenance through cardiac autonomic nerve remodeling. Modulating ANS activity can significantly reduce AF frequency and severity, offering more personalized treatment options. Current research on autonomic interventions for AF shows promise for more effective and personalized treatments.