Ganglionated plexi
Groups of nerves in the heart / From Wikipedia, the free encyclopedia
Ganglionated plexi (GP) comprise the intrinsic cardiac autonomic nervous system composed of autonomic ganglia of the heart atrium and ventricles.[1] The GP are embedded in the epicardial fat pads, consisting of only a few neurons or as many as 400 neurons.[1] GP are spatially close to the pulmonary veins, such that pulmonary vein isolation necessarily affects the GP.[2][3] GP has been shown to be a contributor to atrial fibrillation (AFib), such that ablation of the GP has been a strategy for treatment of AFib.[1] Addition of GP ablation to pulmonary vein isolation has not improved outcomes,[4] but possibly other methods of GP ablation would be more successful.[5] GP ablation alone has been shown to eliminate AFib in approximately three-quarter of AFib patients.[1]
Ligation of the left atrial appendage may reduce AFib by alteration of the GP.[6]
There are intrinsic plexuses that form part of the autonomic nervous system (ANS),[7] the best known intrinsic plexus being the enteric nervous system. The GP are part of the cardiac intrinsic ANS.[5]
In animal models, cardiac overload leads to change in the electrophysiological properties of these neurons, leading to the suggestion that such changes might be relevant to the pathophysiology of heart failure.[8]
In humans, the ganglia are mostly associated with the posterior or superior aspect of the atria.[9] The ganglia mediate at least some of the effects of vagal nerve stimulation on the sinoatrial node, although don't seem to mediate atrioventricular node conduction.[10]