Autonomic denervation using magnetic nanoparticles

Nanoparticles with their unique physical and biochemical properties, such as modifiable surface functionalization and versatility for carrying various therapeutic payloads, are excellent vehicles for targeted drug delivery. The diffuse nature of cardiovascular diseases presents a great challenge to nanotechnology-based drug delivery therapy. Cardiac arrhythmias, frequently caused by heterogeneity of conduction, repolarization, and cell-cell communication, are particularly sensitive to any therapy that targets the presumed arrhythmogenic myocardium but inadvertently introduces further heterogeneity into the heart. In this review, we focus on an alternative approach that is to target the ganglionated plexi of the cardiac autonomic nervous system responsible for many arrhythmias. These ganglionated plexi, serving as the "integration centers" of the cardiac autonomic nervous system, are located in discrete sites on the epicardial surface and potentially can be targeted by magnetic nanoparticles navigated by externally applied magnetic field.