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Review
. 2008 Dec 1;1(4):122.
doi: 10.4022/jafib.122. eCollection 2008 Dec.

Role of the Auotnomic Nerves system in the Creation of Substrate for Atrial Fibrillation

Rishi Arora  1 , Alan H Kadish  1
Affiliations
Review

Role of the Auotnomic Nerves system in the Creation of Substrate for Atrial Fibrillation

Rishi Arora et al. J Atr Fibrillation. .
No abstract available

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Figures

Figure 1.
Figure 1.. Co-localization of sympathetic and parasympathetic nerves within a single nerve bundle in the PV. The figures to the left (A,C,E) show a single large nerve bundle stained only with hematoxylin, while the figures on the right (B,D,F) are double-stained with for sympathetic and parasympathetic nerve elements (blue-sympathetic; brown-parasympathetic). A and B (both 2.5x magnification) show that the nerve bundle (arrows) is located in the fibrofatty tissue on the epicardial aspect of the PV. C and D show that same bundle (arrows) at 10x magnification. E and F show the same bundle at 20x magnification. Sympathetic-parasympathetic co-localization is clearly demonstrated in F. The bundle is predominantly composed of parasympathetic nerve fibers (stained brown) with occasional sympathetic nerve fibers (stained blue; see arrows). Panel G shows a bar-graph demonstrating parasympathetic predominance within individual nerve bundles. The bar-graph shows that in each region, within individual nerve bundles that demonstrate sympathetic and parasympathetic co-localization, the proportion of parasympathetic fibers is much greater than the number of sympathetic fibers. Error bars represent the standard error (SE). S=sympathetic fibers, P=parasympathetic fibers. Modified with permission from Arora R, Ulphani J et al. Neural Substrate for Atrial Fibrillation: Implications for targeted Parasympathetic blockade in the Posterior Left Atrium Am J Physiol-Heart and Circ Physiol 2008; 294(1):H134-44
Figure 2.
Figure 2.. The posterior surface of the left atrium stained for acetylcholinesterase. A. The cholinergic fibers of the vagus nerve are observed to enter the LOM along the left superior pulmonary vein (LSPV). A small nerve branch (N) originating in the LOM is seen to innervate the LSPV. B. White cholinergic fibers originating in the LOM are seen to innervate the LSPV and the left inferior pulmonary vein (LIPV). C. Cholinergic fibers from the posterior left atrial fat pad (PFP) can be seen to innervate the LIPV. D. A small number of cholinergic nerve fibers from the posterior left atrial fat pad can be seen to innervate the right inferior pulmonary vein. Modified with permission from Ulphani J et al. The Ligament of Marshall as a Parasympathetic Conduit. Am J Physiol-Heart and Circ Physiol 2007;293(3):H1629-35
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