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中华心脏与心律电子杂志 ›› 2026, Vol. 14 ›› Issue (02) : 82 -88. doi: 10.3877/cma.j.issn.2095-6568.2026.02.004

专家笔谈

心脏自主神经调节在心房颤动治疗中的研究进展
张杰军, 刘昊, 余意, 石瑞正†()   
  1. 410008 长沙,中南大学湘雅医院心血管内科
  • 收稿日期:2026-06-01 出版日期:2026-06-25
  • 通信作者: 石瑞正
  • 基金资助:
    国家自然科学基金(82370422,82170292); 湖南省卫生健康高层次人才重大专项(20230494); 湖南省卫生健康委科研计划(A202303018910)

Research progress of cardiac autonomic nerve system regulation in the treatment of atrial fibrillation

Jiejun Zhang, Hao Liu, Yi Yu, Ruizheng Shi†()   

  1. Department of Cardiology, Xiangya Hospital of Central South University, Changsha 410008, China
  • Received:2026-06-01 Published:2026-06-25
  • Corresponding author: Ruizheng Shi
引用本文:

张杰军, 刘昊, 余意, 石瑞正. 心脏自主神经调节在心房颤动治疗中的研究进展[J/OL]. 中华心脏与心律电子杂志, 2026, 14(02): 82-88.

Jiejun Zhang, Hao Liu, Yi Yu, Ruizheng Shi. Research progress of cardiac autonomic nerve system regulation in the treatment of atrial fibrillation[J/OL]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2026, 14(02): 82-88.

心房颤动(房颤)是临床较常见的心律失常之一,其发生和维持与心脏自主神经系统的异常调控密切相关。心脏自主神经系统中交感和副交感神经异常调控,以及心脏神经节丛(GP)的异常放电促进了心房电重构和结构重构,加剧心房异位触发及折返活动,并缩短了心房有效不应期、增加心肌异质性,成为房颤触发和维持的关键因素。而心脏自主神经调节技术是以抑制交感神经张力、增加副交感神经张力为目标的治疗方法,主要包括GP消融、心外膜肉毒素注射、低强度迷走神经刺激、肾去神经术、星状神经节消融等。本文拟对心脏自主神经调节在房颤治疗中的作用和策略进行综述。

Atrial fibrillation (AF) is one of the more prevalent arrhythmias in clinical practice. Its initiation and maintenance are closely associated with the dysregulation of the cardiac autonomic nervous system. The imbalance between sympathetic and parasympathetic regulation, combined with the abnormal firing of ganglionated plexi (GP) promotes atrial electrical and structural remodeling. These pathological processes exacerbate atrial ectopic triggering and reentrant activities, shorten the atrial effective refractory period, and increase myocardial spatial heterogeneity, thereby serving as critical mechanisms underlying the genesis and perpetuation of AF. Consequently, cardiac autonomic modulation techniques, which aim to suppress sympathetic activity and enhance parasympathetic tone, have emerged as promising therapeutic strategies. These interventions primarily include GP ablation, epicardial botulinum toxin injection, low-level vagus nerve stimulation, renal denervation, and stellate ganglion ablation. This article reviews the roles and strategies of cardiac autonomic modulation in the management of AF.

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