Heart Autonomic Nervous System: Basic Science and Clinical Implications

The heart has an intrinsic conduction system that consists of specialized cells. The heart receives extensive innervation by both sympathetic and parasympathetic systems of the ANS. The ANS influences most heart functions by affecting the SA node, AV node, myocardium, and small and large vessel walls. The sympathetic system carries an excitatory effect on heart functions. Conversely, the parasympathetic system has inhibitory effects on heart functions. ANS abnormalities in terms of anatomy and physiology can cause various heart abnormalities. ANS abnormalities associated with electrical abnormalities can cause a variety of heart manifestations. Besides electrical abnormalities, ANS also correlates with ischemic heart disease. Following electrical and ischemic instability, ANS also have direct effect on action potential duration restitution. By understanding the mechanism of influence of the anatomy and physiology of the ANS heart and its influence on various heart abnormalities, we can determine the appropriate therapeutic approaches. Therapeutic approaches in neurocardiology fall into two focuses: applying novel treatment and interaction of non-drug and multiple drugs treatments