Letter by Pearman et al. regarding article “Effect of botulinum toxin on inducibility and maintenance of atrial fibrillation in ovine myocardial tissue”

Pearman, Charles M.; Trafford, Andrew W.; Dibb, Katharine M.

doi:10.1111/pace.13184

Cited by 1 publication

(1 citation statement)

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“…Direct epicardial injection of botulinum toxin or CaCl 2 into the major GP induces neurotoxicity and inhibits cardiac ANS hyperactivity ( 12 ). Botulinum toxin is a neurotoxin that has been shown to reduce vagal nerve-induced AERP shortening and prevent ANS remodeling in animal models ( 79 , 80 ). In a clinical pilot study, 60 patients with PxAF undergoing CABG received either botulinum toxin or placebo injections in four major GPs (RAGP, IVCI-IAGP, LSGP, and LIGP).…”

Section: Neuromodulation Methods For Afmentioning

confidence: 99%

Development of neuromodulation for atrial fibrillation: a narrative review

Yang,

Zou,

Wen

et al. 2024

J Thorac Dis

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Background and Objective Atrial fibrillation (AF) is a prevalent clinical arrhythmia with a high incidence of disability and mortality. Autonomic nervous system (ANS) plays a crucial role in the onset and persistence of AF, and can lead to electrophysiological changes and alterations in atrial structure. Both animal models and clinical findings suggest that parasympathetic and sympathetic activity within the cardiac ANS could induce atrial remodeling and AF. Remodeling of the cardiac autonomic nerves is a significant structural basis for promoting AF. Given the challenges faced by conventional pharmacological and atrial ablation techniques in the treatment of AF, increasing attention has been paid to autonomic intervention strategies for AF. Current research has demonstrated that the frequency and severity of AF episodes can be significantly reduced by modulating the activity of ANS. ANS neuromodulation is expected to lead more effective and personalized treatment options for patients with AF. The objective of this review is to provide a broader perspective for future related studies by reviewing preclinical and clinical studies of neuromodulation methods for the treatment of AF, searching for relevant approaches to treat AF, as well as identifying the strengths and weaknesses demonstrated by current relevant studies, and providing researchers with a broader overview of the latest neurological treatments for AF. Methods A narrative review was conducted on the literature on PubMed, WanFang data, and Google Scholar, including all relevant studies published until November 2023. Key Content and Findings In this review, we delve into the innervation of cardiac autonomic nerves, the role of the ANS in the development and maintenance of AF, and the current neuromodulation methods for AF treatment. These methods include stellate ganglion (SG) resection or ablation, vagus nerve stimulation (VNS), thoracic subcutaneous nerve stimulation (ScNS), renal denervation (RDN) therapy, ganglionated plexus (GP) ablation, and epicardial botulinum toxin or CaCl 2 injection. More and more research suggests that neuromodulation methods for the treatment of AF have broad prospects. Conclusions ANS plays a crucial role in AF development and maintenance through cardiac autonomic nerve remodeling. Modulating ANS activity can significantly reduce AF frequency and severity, offering more personalized treatment options. Current research on autonomic interventions for AF shows promise for more effective and personalized treatments.

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Section: Neuromodulation Methods For Afmentioning

confidence: 99%