Figure 4.

Neurophysiological Aspects of Ventricular Arrhythmias

Overview of the neuromyocardial interplay and its impact on ventricular electrophysiology and arrhythmogenesis. Key features of sympathetic ventricular control are highlighted. Remodeling of the parasympathetic nervous system in cardiovascular disease has received significantly less attention (compared to sympathetic remodeling) and may also represent a therapeutic target. Research priorities with the need to address: 1) structural and functional neuronal remodeling; 2) temporal relationship between nerve activity, arrhythmia and autonomic modulation; 3) sex and racial differences; 4) population/patient-centered chronotherapies/lifestyle modification; and 5) reliable prognostic indicators are summarized. Modified from Goldberger et al (202). DAD = delayed after depolarization; EAD = early after depolarization; NGF = nerve growth factor; SCD = sudden cardiac death; VF = ventricular fibrillation; VT = ventricular tachycardia.