Abstract
It is increasingly recognized that the autonomic nervous system (ANS) is
a major contributor in many cardiac arrhythmias. Cardiac ANS can be
divided into extrinsic and intrinsic parts according to the course of
nerve fibers and localization of ganglia and neuron bodies. Although the
role of extrinsic part has historically gained more attention, the
intrinsic cardiac ANS may affect cardiac
function independently as well as
influence the effects of the extrinsic nerves. Catheter based modulation
of the intrinsic cardiac ANS is emerging as a novel therapy for
management of patients with brady and tachy arrhythmias resulting from
hyperactive vagal activation. However, distribution
of intrinsic cardiac nerve plexus
in the human heart and the functional properties of intrinsic cardiac
neural elements remain insufficiently understood. The present review
aims to bring the clinical and anatomical elements of the ICANS
together, by reviewing neuroanatomical terminologies and physiological
functions, in order to guide the clinical electrophysiologist in the
catheter lab, and to serve as a reference for further research.