Non- Isolation Treatment of Atrial Fibrillation: Does Autonomic Nerve Modulation Really Act?

Abstract

Atrial fibrillation (AF) is an abnormal heart rhythm that originates in the top chambers of the heart (atria). Pulmonary vein (PV) ablation is an effective treatment for AF, which has been used widely in clinic; however, significant side effects are difficult to avoid including potential recurrence, pulmonary vein stenosis, systemic thromboembolism, pericardial effusion, cardiac tamponade, esophageal perforation, and phrenic nerve paralysis. These limitations suggest that PV isolation is not a majority determinant of clinical success and promote research toward the development of less aggressive, but equally effective, procedures. First, researchers focus on some non-anti-arrhythmic drug therapy. There is accumulating evidence in support of the anti-arrhythmic effects of non-anti-arrhythmic drugs. Treatments with angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, statins, and omega-3 fatty acids all seem promising, over and above any effect related to the treatment of underlying heart disease. Despite exciting results from animal experiments and promising outcomes from retrospective analyses, there is no robust evidence of specific effects of these drugs to transform current clinical practice (Ardell et al., 2001). Therefore, autonomic nerve modulation has recently become a new strategy for AF management. This chapter aims to study the relationship between ANS and AF; and to investigate the effect of autonomic nerve modulation on AF.