2007 Heart-Brain summit proceedings

Douglas P. Zipes, MD, Director

Division of Cardiology,
Krannert Institute of Cardiology,
Indiana University School of Medicine,
Indianapolis, IN

dzipes@iupui.edu

Click here for Full Article PDF (Heart-brain interactions in cardiac arrhythmias: Role of the autonomic nervous system)

Click here for the abstract

Back to 2007 Proceedings Contents

ABSTRACT

The autonomic nervous system plays an important role in the genesis of ventricular arrhythmias and sudden cardiac death. Evidence is substantial for a neural component in sudden cardiac death. Sympathetic nerve sprouting and regional myocardial hyperinnervation following myocardial injury promote cardiac arrhythmia and sudden cardiac death through several potential mechanisms. Modulating autonomic tone is a potential method to reduce the risk of ventricular arrhythmias. Thoracic spinal cord stimulation is showing promise as a treatment for refractory angina. In addition, spinal cord stimulation has protected against ventricular tachycardia/ventricular fibrillation in animal models of postinfarction heart failure.

CITATIONS

1. Tomaselli GF, Zipes DP
   What causes sudden death in heart failure? Circ Res 2004; 95:754–763.
   http://www.ncbi.nlm.nih.gov/pubmed/15486322

2. Zipes DP
   Autonomic modulation of cardiac arrhythmias. In: Zipes DP, Jalife J, eds. Cardiac Electrophysiology: From Cell to Bedside. 2nd ed. Philadelphia, PA: WB Saunders Co.; 1994:365–395.
3. Schwartz PJ.
   Sympathetic imbalance and cardiac arrhythmias. In: Randall WC, ed. Nervous Control of Cardiovascular Function. New York: Oxford University Press; 1984:225–252.
4. Zipes DP, Rubart M.
   Neural modulation of cardiac arrhythmias and sudden death. Heart Rhythm 2006; 3:108–113.
   http://www.ncbi.nlm.nih.gov/pubmed/16399065
5. Rubart M, Zipes DP.
   Mechanisms of sudden cardiac death. J Clin Invest 2005; 115:2305–2315.
   http://www.ncbi.nlm.nih.gov/pubmed/16138184
6. Stanton MS, Tuli MM, Radtke NL, et al.
   Regional sympathetic denervation after myocardial infarction in humans detected noninvasively using I-123-metaiodobenzylguanidine. J Am Coll Cardiol 1989; 14:1519–1526.
   http://www.ncbi.nlm.nih.gov/pubmed/2809013
7. Paul M, Schäfers M, Kies P, et al.
   Impact of sympathetic innervation on recurrent life-threatening arrhythmias in the follow-up of patients with idiopathic ventricular fibrillation. Eur J Nucl Med Mol Imaging 2006; 33:862–865.
   http://www.ncbi.nlm.nih.gov/pubmed/16612587
8. Chen P-S, Chen LS, Cao J-M, Sharifi B, Karagueuzian HS, Fishbein MC.
   Sympathetic nerve sprouting, electrical remodeling and the mechanisms of sudden cardiac death. Cardiovasc Res 2001; 50:409–416.
   http://www.ncbi.nlm.nih.gov/pubmed/11334845
9. Cao J-M, Fishbein MC, Han JB, et al.
   Relationship between regional cardiac hyperinnervation and ventricular arrhythmia. Circulation 2000; 101:1960–1969.
   http://www.ncbi.nlm.nih.gov/pubmed/10779463
10. Cao JM, Chen LS, KenKnight BH, et al.
    Nerve sprouting and sudden cardiac death. Circ Res 2000; 86:816–821.
    http://www.ncbi.nlm.nih.gov/pubmed/10764417
11. Beyerbach DM, Kovacs RJ, Dmitrienko AA, Rebhun DM, Zipes DP.
    Heart rate corrected QT interval in men increases during winter months. Heart Rhythm 2007; 4:277–281.
    http://www.ncbi.nlm.nih.gov/pubmed/17341387
12. Page RL, Zipes DP, Powell JL, et al.
    Seasonal variation of mortality in the Antiarrhythmics Versus Implantable Defibrillators (AVID) study registry. Heart Rhythm 2004; 1:435–440.
    http://www.ncbi.nlm.nih.gov/pubmed/15851196
13. Pitt B, Gheorghiade M, Zannad F, et al.
    Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction _30%. Eur J Heart Fail 2006; 8:295–301.
    http://www.ncbi.nlm.nih.gov/pubmed/16504579
14. Olgin JE, Takahashi T, Wilson E, Vereckei A, Steinberg H, Zipes DP.
    Effects of thoracic spinal cord stimulation on cardiac autonomic regulation of the sinus and atrioventricular nodes. J Cardiovasc Electrophysiol 2002; 13:475–481.
    http://www.ncbi.nlm.nih.gov/pubmed/12030530
15. Issa ZF, Rosenberger J, Groh WJ, Miller JM, Zipes DP.
    Ischemic ventricular arrhythmias during heart failure: a canine model to replicate clinical events. Heart Rhythm 2005; 2:979–983.
    http://www.ncbi.nlm.nih.gov/pubmed/16171754
16. Issa ZF, Zhou X, Ujhelyi MR, et al.
    Thoracic spinal cord stimulation reduces the risk of ischemic ventricular arrhythmias in a postinfarction heart failure canine model. Circulation 2005; 111:3217–3220.
    http://www.ncbi.nlm.nih.gov/pubmed/15956128
17. Issa ZF, Ujhelyi MR, Hildebrand KR, et al.
    Intrathecal clonidine reduces the incidence of ischemic provoked ventricular arrhythmias in a canine postinfarction heart failure model. Heart Rhythm 2005; 2:1122–1127.
    http://www.ncbi.nlm.nih.gov/pubmed/16188594
18. Lopshire JC, Zhou X, Rosenberger J, et al.
    Spinal cord stimulation improves ventricular function and reduces ventricular arrhythmias in a canine post-infarction heart failure model [abstract]. Heart Rhythm 2007; 4(5 Suppl):S105.
19. Zipes DP, Camm AJ, Borggrefe M, et al.
    ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol 2006; 48:e247–e346.
    http://www.ncbi.nlm.nih.gov/pubmed/16949478
20. Lopshire JC, Zipes DP.
    Sudden cardiac death: better understanding of risks, mechanisms, and treatment. Circulation 2006; 114:1134–1136.
    http://www.ncbi.nlm.nih.gov/pubmed/16966594