Heart failure differentially modulates natural (Sinoatrial node) and ectopic (pulmonary veins) pacemakers: Mechanism and therapeutic implication for atrial fibrillation

Chao Shun Chan; Yung Kuo Lin; Yao Chang Chen; Yen Yu Lu; Shih Ann Chen; Yi Jen Chen

doi:10.3390/ijms20133224

Heart failure differentially modulates natural (Sinoatrial node) and ectopic (pulmonary veins) pacemakers: Mechanism and therapeutic implication for atrial fibrillation

Chao Shun Chan, Yung Kuo Lin, Yao Chang Chen, Yen Yu Lu, Shih Ann Chen, Yi Jen Chen

Research output: Contribution to journal › Review article

2 Citations (Scopus)

Abstract

Heart failure (HF) frequently coexists with atrial fibrillation (AF) and dysfunction of the sinoatrial node (SAN), the natural pacemaker. HF is associated with chronic adrenergic stimulation, neurohormonal activation, abnormal intracellular calcium handling, elevated cardiac filling pressure and atrial stretch, and fibrosis. Pulmonary veins (PVs), which are the points of onset of ectopic electrical activity, are the most crucial AF triggers. A crosstalk between the SAN and PVs determines PV arrhythmogenesis. HF has different effects on SAN and PV electrophysiological characteristics, which critically modulate the development of AF and sick sinus syndrome. This review provides updates to improve our current understanding of the effects of HF in the electrical activity of the SAN and PVs as well as therapeutic implications for AF.

Original language	English
Article number	3224
Journal	International Journal of Molecular Sciences
Volume	20
Issue number	13
DOIs	https://doi.org/10.3390/ijms20133224
Publication status	Published - Jul 1 2019

Keywords

Atrial fibrillation
Heart failure
Pulmonary veins
Sinoatrial node
Sinoatrial node dysfunction
Heart Failure/drug therapy
Animals
Pulmonary Veins/drug effects
Humans
Sinoatrial Node/drug effects
Atrial Fibrillation/drug therapy
Anti-Arrhythmia Agents/pharmacology

ASJC Scopus subject areas

Molecular Biology
Spectroscopy
Catalysis
Inorganic Chemistry
Computer Science Applications
Physical and Theoretical Chemistry
Organic Chemistry

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Chan, C. S., Lin, Y. K., Chen, Y. C., Lu, Y. Y., Chen, S. A., & Chen, Y. J. (2019). Heart failure differentially modulates natural (Sinoatrial node) and ectopic (pulmonary veins) pacemakers: Mechanism and therapeutic implication for atrial fibrillation. International Journal of Molecular Sciences, 20(13), [3224]. https://doi.org/10.3390/ijms20133224

Heart failure differentially modulates natural (Sinoatrial node) and ectopic (pulmonary veins) pacemakers : Mechanism and therapeutic implication for atrial fibrillation. / Chan, Chao Shun ; Lin, Yung Kuo; Chen, Yao Chang; Lu, Yen Yu; Chen, Shih Ann; Chen, Yi Jen.

In: International Journal of Molecular Sciences, Vol. 20, No. 13, 3224, 01.07.2019.

Research output: Contribution to journal › Review article

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abstract = "Heart failure (HF) frequently coexists with atrial fibrillation (AF) and dysfunction of the sinoatrial node (SAN), the natural pacemaker. HF is associated with chronic adrenergic stimulation, neurohormonal activation, abnormal intracellular calcium handling, elevated cardiac filling pressure and atrial stretch, and fibrosis. Pulmonary veins (PVs), which are the points of onset of ectopic electrical activity, are the most crucial AF triggers. A crosstalk between the SAN and PVs determines PV arrhythmogenesis. HF has different effects on SAN and PV electrophysiological characteristics, which critically modulate the development of AF and sick sinus syndrome. This review provides updates to improve our current understanding of the effects of HF in the electrical activity of the SAN and PVs as well as therapeutic implications for AF.",

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