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Autonomic dysregulation and atrial arrhythmias
Aleksei Mikhailov1, Rishi Arora1, Anna Pfenniger2
1Biological Sciences Division, Department of Medicine, University of Chicago, Chicago, Illinois, United States.
American Journal of Physiology. Cell Physiology
|September 29, 2025
Summary
The autonomic nervous system (ANS) plays a key role in atrial fibrillation (AF). Understanding and targeting ANS dysregulation offers promising new strategies for AF prevention and treatment.
Area of Science:
- Cardiology
- Neuroscience
- Electrophysiology
Background:
- The autonomic nervous system (ANS) and its dysregulation are implicated in atrial arrhythmias like atrial fibrillation (AF).
- Cardiac autonomic dysfunction can initiate and sustain AF.
- The ANS itself undergoes remodeling in the presence of AF.
Purpose of the Study:
- To review the role of the ANS in AF.
- To discuss neuromodulation strategies for AF prevention and treatment.
- To highlight the potential of ANS-targeted therapies for AF.
Main Methods:
- Review of anatomical and physiological aspects of the cardiac nervous system.
- Analysis of sympathetic and parasympathetic effects on atrial electrophysiology.
- Discussion of current and emerging neuromodulation techniques.
Main Results:
- ANS dysregulation contributes to AF initiation and maintenance.
- Functional and structural remodeling of the ANS occurs in AF.
- Neuromodulation strategies, including nerve stimulation and gene therapy, show therapeutic potential.
Conclusions:
- Autonomic mechanisms are central to AF pathophysiology.
- ANS-targeted approaches represent a promising frontier in AF management.
- Advancements in diagnostics and therapeutics enhance the potential of ANS-directed AF treatments.
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