Topography of cardiac ganglia in the adult human heart

Abstract

Published descriptions of the topography of cardiac ganglia in the human heart are limited and present conflicting results. This study was carried out to determine the distribution of cardiac ganglia in adult human hearts and to address these conflicts. Hearts obtained from autopsies and heart transplant procedures were sectioned, stained, and examined. Results indicate that the largest populations of cardiac ganglia are near the sinoatrial and atrioventricular nodes. Smaller collections of ganglia exist on the superior left atrial surface, the interatrial septum, and the atrial appendage-atrial junctions. Ganglia also exist at the base of the great vessels and the base of the ventricles. The right atrial free wall, atrial appendages, trunk of the great vessels, and most of the ventricular myocardium are devoid of cardiac ganglia. These findings suggest modifications to surgical procedures involving incisions through regions concentrated with ganglia to minimize arrhythmias and related complications. Repairs of septal defects, valvular procedures, and congenital reconstructions, such as the Senning and Fontan operations, involve incisions through areas densely populated with cardiac ganglia. The current standard procedure for orthotopic heart transplantation severs cardiac ganglia and their projections to nodal and muscular tissue. One modification of the current heart transplantation procedure, involving bicaval anastomosis, preserves atrial anatomy and the cardiac ganglia. Preservation of cardiac ganglia within the donor heart may provide additional neuronal substrate for intracardiac processing and targets for regenerating nerve fibers to the donor heart.

Catheter Ablation of Right Atrial Ganglionated Plexi in Patients With Vagal Paroxysmal Atrial Fibrillation

“…20 -26 Anatomic studies showed [27][28][29] the high prevalence of cardiac ganglia in the posterior surface of the right atrium (RA). Experimental data suggested the potential relevant role of RA GP in the AF initiation and maintenance.…”

“…[27][28][29] We have considered as ablation sites (radiofrequency energy at 60°, 30 -70 W for 30 -60 seconds, Stockert Biosense Webster) the following areas where all the presumed RA GP clusters are located ( Figure 1A and 1B): the superoposterior area (superior RA GP, adjacent to the junction of the superior vena cava [SVC] and the posterior surface of the RA), the middle posterior area (posterior RA GP, posterior surface of the RA adjacent the interatrial groove), the inferoposterior area (GP placed between inferior vena cava, coronary sinus ostium and near the atrioventricular groove). Considering that the exact anatomic borders of GP clusters are unknown, we decided to perform this ablation procedure delivering an expanded number of radiofrequency applications and forming a cloudlike shape ablation model, previously described in detail.…”

Variabilidade da frequência cardíaca e infecções pulmonares pós revascularização miocárdica

“…In relation to HRV of patients undergoing surgical myocardial revascularization (SMR), in turn, studies have shown that its reduction in the postoperative period is associated with a higher risk of complications such as arrhythmias and death 7,8 .…”

“…Studies on HRV of patients undergoing surgical myocardial revascularization (SMR) showed that its reduction in the postoperative period is associated with a higher risk of complications such as arrhythmias and death 7,8 . Godoy et al's study 5 , in turn, showed that the analysis of HRV in the nonlinear domain in the preoperative period of patients undergoing elective SMR makes it possible to detect subgroups at a high risk for postoperative complications, which makes this analysis a new tool for the prediction of clinical complications in the assessment of patients undergoing major surgeries.…”

Autonomic cardiac nerves: literature review

“…Horackova et al [30] found cardiac ganglia in the guinea pig mostly in the atrial septum and around the openings of venae cavae to the right atrium; they contained 85-90% of neurons, while the rest were located individually. The results of studies by Singh et al [60] performed in the hearts of adult humans during autopsy or during transplantation procedures have shown that the largest populations of cardiac ganglia are near the sinoatrial and atrioventricular nodes. Smaller collections of ganglia exist on the superior left atrial surface, the interatrial septum, and the atrial appendage-atrial junctions.…”