Disruption of cardiac cholinergic neurons enhances susceptibility to ventricular arrhythmias

Nat Commun. 2017 Jan 27:8:14155. doi: 10.1038/ncomms14155.

Abstract

The parasympathetic nervous system plays an important role in the pathophysiology of atrial fibrillation. Catheter ablation, a minimally invasive procedure deactivating abnormal firing cardiac tissue, is increasingly becoming the therapy of choice for atrial fibrillation. This is inevitably associated with the obliteration of cardiac cholinergic neurons. However, the impact on ventricular electrophysiology is unclear. Here we show that cardiac cholinergic neurons modulate ventricular electrophysiology. Mechanical disruption or pharmacological blockade of parasympathetic innervation shortens ventricular refractory periods, increases the incidence of ventricular arrhythmia and decreases ventricular cAMP levels in murine hearts. Immunohistochemistry confirmed ventricular cholinergic innervation, revealing parasympathetic fibres running from the atria to the ventricles parallel to sympathetic fibres. In humans, catheter ablation of atrial fibrillation, which is accompanied by accidental parasympathetic and concomitant sympathetic denervation, raises the burden of premature ventricular complexes. In summary, our results demonstrate an influence of cardiac cholinergic neurons on the regulation of ventricular function and arrhythmogenesis.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Animals
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / adverse effects*
  • Cholinergic Neurons / drug effects
  • Cholinergic Neurons / physiology*
  • Cyclic AMP / metabolism
  • Disease Susceptibility / physiopathology
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Atria / physiopathology
  • Heart Rate / drug effects
  • Heart Rate / physiology
  • Heart Ventricles / innervation*
  • Heart Ventricles / metabolism
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Middle Aged
  • Neurotransmitter Agents / pharmacology
  • Parasympathetic Nervous System / drug effects
  • Parasympathetic Nervous System / injuries
  • Parasympathetic Nervous System / physiopathology*
  • Retrospective Studies
  • Ventricular Function / drug effects
  • Ventricular Function / physiology

Substances

  • Neurotransmitter Agents
  • Cyclic AMP