Key result
Neuromodulation techniques offer potential adjunctive benefits to PVI for AFib management.
Why the study?
AF remains difficult to durably treat, and neuromodulation of the autonomic nervous system constitutes an emerging therapeutic approach.
Neuromodulation of the autonomic nervous system constitutes an emerging therapeutic approach for the management of atrial fibrillation.
May support adjunctive neuromodulation in select AF ablation; leaves open need for randomized trials before practice change.
As the most common sustained arrhythmia, AF is a complex clinical entity which remains a difficult condition to durably treat in the majority of patients. Over the past few decades, the management of AF has focused mainly on pulmonary vein triggers for its initiation and perpetuation. It is well known that the autonomic nervous system (ANS) has a significant role in the milieu predisposing to the triggers, perpetuators and substrate for AF. Neuromodulation of ANS – ganglionated plexus ablation, vein of Marshall ethanol infusion, transcutaneous tragal stimulation, renal nerve denervation, stellate ganglion block and baroreceptor stimulation – constitute an emerging therapeutic approach for AF. The purpose of this review is to summarise and critically appraise the currently available evidence for neuromodulation modalities in AF.
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Aksu et al. (2023) conducted a review in Atrial Fibrillation. Neuromodulation (e.g., Ganglionated Plexus Ablation, Vein of Marshall Ethanol Infusion) vs. Pulmonary vein isolation alone was evaluated. Neuromodulation techniques, including ganglionated plexus ablation and vein of Marshall ethanol infusion, offer potential adjunctive benefits to pulmonary vein isolation for the management of atrial fibrillation.
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