Reviews Autonomic Nervous System and Arrhythmias

Autonomic tones is an essential factor in the genesis of both supraventricular and ventricular arrhythmias as well as the substrate for the arrhythmia and the triggering factors. Although the role of the autonomic nervous system has been well established in many elegant experimental studies, these effects may not seem to be obvious in many elinical arrhythmias due to lack of simple and sensitive tests to evaluate the autonomic nervous system. Autonomic nervous system, especially the sympathetic arm is involved in all of the proposed mechanisms in the genesis of tachyarrhythmias (abnormal automaticity, triggered activity and reentry). Sympathetic and parasympathetic nervous system play an essential role in the genesis, perpetuation, termination and prevention of arrhythmias where the parts of the heart, richly innervated by the autonomic nervous system such as the sinus node and the atrioventricular node are involved. Moreover, the role of the autonomic nervous system has been shown in various ventricular arrhythmias and sudden cardiac death. The unique antiarrhythmic action of beta blockers reflect the therapeutic efficacy of autonomic modulation.