Heart-brain interactions in cardiac arrhythmia

Area of Science:

• Neurocardiology
• Cardiac Electrophysiology
• Autonomic Nervous System

Background:

• Higher brain centers, brain stem, and autonomic nerves interact to influence cardiac electrophysiology and arrhythmogenesis.
• Mental stress and emotion are recognized triggers for arrhythmias and sudden cardiac death.
• Cardiac ion channel mutations (channelopathies) increase susceptibility to arrhythmias, with some sensitive to autonomic stimulation.

Purpose of the Study:

• To review the current understanding of brain-heart interactions in arrhythmogenesis.
• To explore the role of central neural circuitry in the brain-heart axis.
• To identify potential therapeutic targets within these pathways for preventing sudden cardiac death.

Main Methods:

• Review of existing literature on neurocardiology and cardiac electrophysiology.
• Examination of evidence linking mental stress, emotion, and cardiac events.
• Analysis of findings from molecular cardiology and functional neuroimaging studies.

Main Results:

• Substantial evidence supports the interactive system between higher brain function, brain stem, autonomic nerves, and the heart.
• Specific channelopathies like Long QT syndrome and Brugada syndrome demonstrate autonomic modulation.
• Functional neuroimaging has elucidated the central neural circuitry of the brain-heart axis.

Conclusions:

• Brain-heart interactions are crucial in explaining sudden cardiac events and arrhythmia.
• Central pathways translating stress into autonomic effects on the heart are potential therapeutic targets.
• Understanding these interactions provides insights for novel therapies to prevent sudden cardiac death.