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Intrinsic Cardiac Autonomic Nervous System: what do clinical electrophysiologists need to know about the ‘heart brain’?
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  • Tolga Aksu,
  • Rakesh Gopinathannair,
  • Dhiraj Gupta,
  • Dainius Pauza
Tolga Aksu
Kocaeli Derince Egitim ve Arastirma Hastanesi
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Rakesh Gopinathannair
Kansas City Heart Rhythm Institute
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Dhiraj Gupta
Liverpool Heart and Chest Hospital
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Dainius Pauza
Lithuanian University of Health Sciences
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Abstract

It is increasingly recognized that the autonomic nervous system (ANS) is a major contributor in many cardiac arrhythmias. Cardiac ANS can be divided into extrinsic and intrinsic parts according to the course of nerve fibers and localization of ganglia and neuron bodies. Although the role of extrinsic part has historically gained more attention, the intrinsic cardiac ANS may affect cardiac function independently as well as influence the effects of the extrinsic nerves. Catheter based modulation of the intrinsic cardiac ANS is emerging as a novel therapy for management of patients with brady and tachy arrhythmias resulting from hyperactive vagal activation. However, distribution of intrinsic cardiac nerve plexus in the human heart and the functional properties of intrinsic cardiac neural elements remain insufficiently understood. The present review aims to bring the clinical and anatomical elements of the ICANS together, by reviewing neuroanatomical terminologies and physiological functions, in order to guide the clinical electrophysiologist in the catheter lab, and to serve as a reference for further research.

Peer review status:ACCEPTED

11 Feb 2021Submitted to Journal of Cardiovascular Electrophysiology
12 Feb 2021Submission Checks Completed
12 Feb 2021Assigned to Editor
14 Feb 2021Reviewer(s) Assigned
18 Apr 2021Review(s) Completed, Editorial Evaluation Pending
19 Apr 2021Editorial Decision: Revise Minor
20 Apr 20211st Revision Received
22 Apr 2021Submission Checks Completed
22 Apr 2021Assigned to Editor
22 Apr 2021Reviewer(s) Assigned
22 Apr 2021Review(s) Completed, Editorial Evaluation Pending
23 Apr 2021Editorial Decision: Accept