The nervous heart

Ripplinger, Crystal M.; Noujaim, Sami F.; Linz, Dominik

doi:10.1016/j.pbiomolbio.2015.12.015

Cited by 51 publications

(44 citation statements)

References 129 publications

(169 reference statements)

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“…Photoactivation using the micro LED, which provided the highest irradiance in our studies, produced a response similar to ubiquitous pharmacologic activation of muscarinic receptors, as observed with bethanechol. In addition to the effects of increased irradiance, the micro LED was more localized to the right atrial epicardium, having a high concentration of parasympathetic innervation, particularly at the RA/SVC junction (Ripplinger et al, 2016). Light from the micro LED could be oriented to selectively illuminate areas of the atria, such as the SA node, resulting in heart rate reductions without significant increases in AV delay, similar to the results of previous studies Sampaio et al, 2003).…”

Section: Discussionsupporting

confidence: 78%

Sudden heart rate reduction upon optogenetic release of acetylcholine from cardiac parasympathetic neurons in perfused hearts

Moreno

Endicott

Skancke

et al. 2018

Preprint

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Key Message: Optogenetic photoactivation of intrinsic cardiac neurons provides immediate, tissuespecific stimulation with minimal cross-reactivity. Our results demonstrate that selective expression of channelrhodopsin within cardiac cholinergic neurons enables photoactivated release of acetylcholine, thereby instantaneously slowing sinus rate and altering atrioventricular conduction. This provides for indepth examination of the endogenous interplay between cardiac autonomic neurons and the functional outcomes of downstream post-synaptic receptor activation.

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Section: Discussionsupporting

confidence: 78%

Sudden heart rate reduction upon optogenetic release of acetylcholine from cardiac parasympathetic neurons in perfused hearts

Moreno

Endicott

Skancke

et al. 2018

Preprint

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“…Larger GPs observed close to the PV ostia serve as autonomic integration centers modulating cardiac excitability. 19 This widely distributed structure cannot be fully targeted, and a comprehensive and selective approach, meant to promote attenuation instead of a total vagal blockade, is required.…”

Section: Discussionmentioning

confidence: 99%

“…EnSite Velocity (St. Jude Medical, St. Paul, MN) system was used in the remaining 4 patients (PIN 9, 10, 11, and 13). Specific atrium sites were empirically identified as GP by presumed anatomic location based on previous works 18,19 (anatomic mapping):…”

Section: Gp Mapping and Ablationmentioning

confidence: 99%

“…Late vagal tonus recovery after denervation with different techniques is an important, well-demonstrated issue. [9][10][11][12]14 Ripplinger et al 19 describes the neuroanatomy of the atria as abundant intrinsic ganglia more widely distributed than previously thought. Therefore, a significant portion of the vagal innervation after radiofrequency lesions may possibly remain stunned but still functional.…”

Section: Downloaded From Targets and End Points In Cardiac Denervationmentioning

confidence: 99%

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Targets and End Points in Cardiac Autonomic Denervation Procedures

Rivarola

Hachul

et al. 2017

Circ: Arrhythmia and Electrophysiology

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Background-Autonomic denervation is an alternative approach for patients with symptomatic bradycardia. No consensus exists on the critical targets and end points of the procedure. The aim of this study was to identify immediate end points and critical atrial regions responsible for vagal denervation. Methods and Results-We enrolled 14 patients (50% men; age: 34.0±13.8 years) with cardioinhibitory syncope, advanced atrioventricular block or sinus arrest, and no structural heart disease. Anatomic mapping of ganglionated plexuses was performed, followed by radiofrequency ablation. Heart rate, sinus node recovery time, Wenckebach cycle length, and atrial-His (AH) interval were measured before and after every radiofrequency pulse. Wilcoxon signed-rank test was used for comparison. Significant shortening of the R-R interval (P=0.0009), Wenckebach cycle length (P=0.0009), and AH intervals (P=0.0014) was observed after ablation. The heart rate elevation was 23.8±12.5%, and the Wenckebach cycle length and AH interval shortening was 18.1±11% and 24.6±19%, respectively. Atropine bolus injection (0.04 mg/kg) did not increase heart rate further. Targeting a single spot of the left side (64% of the patients) or right side (36%) of the interatrial septum was observed to be responsible for ≥80% of the final R-R and AH interval shortening during ablation. Conclusions-Targeting specific sites of the interatrial septum is followed by an increase in heart rate and atrioventricular nodal conduction properties and might be critical for vagal attenuation. The R-R interval, Wenckebach cycle length, and AH interval shortening, associated with a negative response to atropine, could be considered immediate end points of the procedure.

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“…Second to neurologically linked fatalities are deaths caused by cardiac failure (Lawlor et al, 2002;Oppenheimer and Hachinski, 1992). In the few decades, plenty of researches proved the close pathological link between ischemic stroke and cardiac arrest (Finsterer and Wahbi, 2014;Gonzales-Portillo et al, 2016;Palma and Benarroch, 2014;Ripplinger et al, 2016). Two newly published clinical investigations confirmed the relationship between atrial fibrillation and cryptogenic stroke (Gladstone et al, 2014;Sanna et al, 2014).…”

Section: Introductionmentioning

confidence: 99%