Influence of myocardial ischemia and infarction on autonomic innervation of heart.
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Implication
Neural sidedness may shape post-MI arrhythmia risk; leaves open targeted interventional trials.
Key Points
- To review the effects of myocardial ischemia and infarction on cardiac autonomic neural innervation and describe how these changes modulate the genesis of cardiac arrhythmias.
- Synthesized findings from physiological and anatomical studies evaluating extracardiac and intracardiac sympathetic and parasympathetic innervation of the heart.
- Characterized lateralized neural pathways ('sidedness') distributing vagal and sympathetic inputs to the sinus node and atrioventricular (AV) node.
- Autonomic neural input exhibits sidedness, with right-sided sympathetic and vagus nerves predominantly influencing the sinus node, whereas left-sided nerves exert greater influence over the atrioventricular node.
- Parasympathetic entry points follow specific anatomical trajectories, with right vagal projections accessing the superior atrial and sinus nodal regions via the superior vena cava-right atrial junction, azygos vein, and pulmonary vein complexes.
Cite This Study
Douglas P. Zipes (1990) studied this question.