AUTHOR=Vandenberk Bert , Haemers Peter , Morillo Carlos TITLE=The autonomic nervous system in atrial fibrillation—pathophysiology and non-invasive assessment JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=10 YEAR=2024 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1327387 DOI=10.3389/fcvm.2023.1327387 ISSN=2297-055X ABSTRACT=

The autonomic nervous system plays a crucial role in atrial fibrillation pathophysiology. Parasympathetic hyperactivity result in a shortening of the action potential duration, a reduction of the conduction wavelength, and as such facilitates reentry in the presence of triggers. Further, autonomic remodeling of atrial myocytes in AF includes progressive sympathetic hyperinnervation by increased atrial sympathetic nerve density and sympathetic atrial nerve sprouting. Knowledge on the pathophysiological process in AF, including the contribution of the autonomic nervous system, may in the near future guide personalized AF management. This review focuses on the role of the autonomic nervous system in atrial fibrillation pathophysiology and non-invasive assessment of the autonomic nervous system.