Interactive atrial neural network: Determining the connections between ganglionated plexi

Area of Science:

• Cardiac Electrophysiology
• Autonomic Nervous System Function
• Cardiac Innervation

Background:

• The electrophysiologic functions of the intrinsic cardiac autonomic nervous system (ANS) are not well understood.
• Understanding the intrinsic cardiac ANS is crucial for managing cardiac arrhythmias.

Purpose of the Study:

• To investigate the functional interactions between ganglionated plexi within the intrinsic cardiac ANS.
• To elucidate the role of specific cardiac autonomic ganglia in modulating cardiac function.

Main Methods:

• Surgical exposure of anterior right, inferior right, and superior left ganglionated plexi in 21 dogs.
• Electrical stimulation and subsequent ablation of ganglionated plexi.
• Assessment of sinus rate, AV nodal conduction (AH interval), and ventricular rate during atrial fibrillation.

Main Results:

• Stimulation of anterior right ganglionated plexi prolonged AH interval and slowed sinus and ventricular rates.
• Ablation of inferior right ganglionated plexi eliminated AV conduction inhibition by anterior right ganglionated plexi.
• Superior left ganglionated plexi stimulation affected sinus and AV nodal function, with sinus slowing attenuated by anterior right ganglionated plexi ablation.

Conclusions:

• Demonstrates functional interconnections between cardiac ganglionated plexi in modulating sinus and AV nodal function.
• Supports the clinical significance of intrinsic cardiac ANS interconnections for atrial fibrillation ablation targets.