The autonomic nervous system in atrial fibrillation-pathophysiology and non-invasive assessment

Bert Vandenberk; Peter Haemers; Carlos Morillo

doi:10.3389/fcvm.2023.1327387

The autonomic nervous system in atrial fibrillation-pathophysiology and non-invasive assessment

Front Cardiovasc Med. 2024 Jan 4:10:1327387. doi: 10.3389/fcvm.2023.1327387. eCollection 2023.

Authors

Bert Vandenberk^{1

2}, Peter Haemers^{1

2}, Carlos Morillo³

Affiliations

¹ Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
² Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
³ Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada.

Abstract

The autonomic nervous system plays a crucial role in atrial fibrillation pathophysiology. Parasympathetic hyperactivity result in a shortening of the action potential duration, a reduction of the conduction wavelength, and as such facilitates reentry in the presence of triggers. Further, autonomic remodeling of atrial myocytes in AF includes progressive sympathetic hyperinnervation by increased atrial sympathetic nerve density and sympathetic atrial nerve sprouting. Knowledge on the pathophysiological process in AF, including the contribution of the autonomic nervous system, may in the near future guide personalized AF management. This review focuses on the role of the autonomic nervous system in atrial fibrillation pathophysiology and non-invasive assessment of the autonomic nervous system.

Keywords: atrial fibrillation; autonomic nervous system; heart rate turbulence; heart rate variability; non-invasive assessment; pathophysiology.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article.