Advances in Cardiac Pacing and Neural Control Strategies: Basic, Translational and Clinical Research

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Background

The autonomic nervous system plays a central role in the pathogenesis of multiple cardiac arrhythmias, including atrial fibrillation and ventricular tachycardia. Multiple studies have investigated the utility of different autonomic modulation modalities in preventing cardiac arrhythmias, presenting promising results in preclinical experiments and preliminary studies in humans. Yet the need for optimization of the stimulation parameters and gaining a mechanistic understanding of the effects of parasympathetic activation on cardiac electrophysiology to identify appropriate biomarkers, is warranted by the disappointing results of randomized clinical trials of autonomic modulation therapies.
Similarly, multiple studies investigating pacing techniques for controlling the heart in real-time and preventing the onset of life-threatening arrhythmias have focused on the prediction and control of cardiac alternans, a suggested precursor to fatal tachy-arrhythmias. However, given the spatiotemporal and structural complexity of the human heart, designing algorithms to effectively suppress alternans and prevent fatal cardiac rhythms has been challenging, especially in chronic disease and ambulatory models. Hence, there is an unmet clinical need to decipher electrical intervention and autonomic modulation techniques to inhibit or control the onset of abnormal cardiac rhythms.

The goal of this Research Topic is to cover novel treatment strategies for the prediction, prevention and control of arrhythmias, based on cardiac pacemaking and neuromodulation techniques. We invite articles describing the recent advances in cardio-neurology by providing insights into approaches for controlling abnormal cardiac rhythms using electrical interventions.

We welcome original research, brief reports or review articles on the following themes:

1) pacing strategies for prevention or control of cardiac alternans and arrhythmias
2) application of neuromodulation techniques like vagal stimulation for control of cardiac arrhythmias
3) novel pacemaker strategies in healthy or diseased, in-silico, animal or clinical models
4) mechanistic insights into effect of parasympathetic or sympathetic activation on cardiac electrophysiology
5) techniques for cardiac pacing or neuromodulation in ambulatory models

Keywords: cardiac pacing, alternans, arrhythmias, neuromodulation, vagal stimulation

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