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Autonomic Nervous System and Cardiac Arrhythmias

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Autonomic Disorders in Clinical Practice

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Abstract

The Autonomic Cardiac Nervous System (ACNS) is a complex neural network responsible for the autonomic cardiac control and organised in various and multilevel parts of the nervous system. Releasing neurotransmitters, this autonomic control can result in dromotropy, chronotropy, lusitropy and inotropy effect and Autonomic Nervous System-mediated heart rhythm disturbances. The most frequent ACNS-related heart rhythm disturbances are Inappropriate Sinus Tachycardia (IST), Nocturnal bradyarrhythmias, Sinus node dysfunction (SND), Atrioventricular node dysfunction, Atrial fibrillation, Ventricular tachycardias. IST is the persistent heart rate of more than 100 bpm without a trigger or with an out-of-proportion trigger. Nocturnal bradyarrhythmias are any heart rhythm with a rate less than 60 bpm, and they are more common in young and sportive people and reduce in frequency in middle-aged and older people. Sinus node dysfunction (SND) is a chronic condition in which the deterioration of sinoatrial nodal function results in abnormalities such as sinus bradycardia, sinus pauses, sinus arrest, sinoatrial nodal exit block and chronotropic incompetence. Atrioventricular node dysfunction results in a progressive prolongation of the PR interval until the complete AV nodal block. The AV nodal block exists in three degrees: First-degree AV block, Mobitz type 1 second-degree AV block, Mobitz type 2 second-degree AV block, 2:1 AV block, Second-degree AV block, type II advanced, High-degree AV block. Atrial fibrillation is an atrial arrhythmia characterised by a high rate of irregular activation of atria (with ineffective atrial contraction) and a variable conduction to ventricle with typical irregularity of R-R interval. Ventricular tachycardias is a tachyarrhythmia that originates from ventricular myocardium cells or from the conduction system distal to His bundle bifurcation. Ventricular tachycardia (VT) is a series of three or more ventricular beats, and sudden cardiac death is the extreme consequence of VT.

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Authors and Affiliations

  1. Cardiology Unit, IRCCS INRCA, Ancona, Italy

    Alessio Menditto, Lucia Mancinelli & Roberto Antonicelli

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  1. Alessio Menditto
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  2. Lucia Mancinelli
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  3. Roberto Antonicelli
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Correspondence to Roberto Antonicelli .

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Editors and Affiliations

  1. Emergency Neurology, Fondazione Istituto Neurologico Nazionale Mondino, Pavia, Italy

    Giuseppe Micieli

  2. Dept. of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany

    Max Hilz

  3. Neurology, Operative Director IRCCS ISNB, University of Bologna, Bologna, Italy

    Pietro Cortelli

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Menditto, A., Mancinelli, L., Antonicelli, R. (2023). Autonomic Nervous System and Cardiac Arrhythmias. In: Micieli, G., Hilz, M., Cortelli, P. (eds) Autonomic Disorders in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-43036-7_4

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  • DOI: https://doi.org/10.1007/978-3-031-43036-7_4

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