Autonomic control of heart rate: Pharmacological and nonpharmacological modulation

摘要: The evidence of the predictive value autonomic markers has generated a growing interest for interventions able to influence control heart rate. hypothesis is that an increase in cardiac vagal activity as detected by rate variability (HRV) or baroreflex sensitivity (BRS) may be beneficial ischemic heart. Numerous experimental data support augmenting might protective against lethal arrhythmias. Among them ventricular fibrillation during acute myocardial ischemia largely prevented electrical stimulation right cervical vagus pharmacological cholinergic receptors with oxotremorine. There inherent danger so far unwarranted assumption modification HRV BRS translates directly protection. This not case. It should remembered true target improvement stability and are just activity. Low dose scopolamine increases patients prior infarction. observation, combined elevated antifibrillatory, after MI. We tested low clinically relevant preparation sudden death which other vagomimetic effective found this intervention does indeed but minimal antifibrillatory effects. contrast exercise training same model had marked effect on both at time provided strong protection from fibrillation. Thus, based current knowledge it seems appropriate call caution before attributing excessive importance changes „markers“of absence clear-cut causal relation effect.