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Stirbys P. From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery. J Atr Fibrillation. 2016;8(5):1377doi: 10.4022/jafib.1377.
Stirbys, P. (2016). From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery. Journal of atrial fibrillation, 8(5), 1377. https://doi.org/10.4022/jafib.1377
Stirbys, Petras. "From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery." Journal of atrial fibrillation vol. 8,5 (2016): 1377. doi: https://doi.org/10.4022/jafib.1377
Stirbys P. From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery. J Atr Fibrillation. 2016 Feb 29;8(5):1377. doi: 10.4022/jafib.1377. eCollection 2016. PMID: 27909483; PMCID: PMC5089496.
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J Atr Fibrillation. 2016 Feb 29;8(5):1377. doi: 10.4022/jafib.1377. eCollection 2016.

From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery.

Journal of atrial fibrillation

Petras Stirbys

Affiliations

  1. The Department of Cardiology, Hospital of Lithuanian University of Health Sciences , Kaunas Clinic, Kaunas, Lithuania.

PMID: 27909483 PMCID: PMC5089496 DOI: 10.4022/jafib.1377

Abstract

The underlying pathophysiology of supraventricular and ventricular arrhythmias remains a matter of intense investigation. Though evolving, the contemporary explanations do not encompass all aspects of arrhythmogenicity. An improved understanding of arrhythmia substrate is needed to augment therapeutic capabilities. Our observation and literature sources demonstrate relatively high incidence of transitory arrhythmias which are non-intentionally generated by the endocardial lead/catheter manipulation. These findings are interesting and potentially may crystallize the reflex-dependent proarrhythmic cardiac activity. Herein we suggest the "reflexogenic arrhythmogenicity" concept extending an overall spectrum of known hypotheses. Cardiovascular reflex action can be categorized into three-tiered levels - intra-cellular, inter-cellular and inter-organic. The first two levels of the triplicate system reside within the cardiac anatomical landmarks (in fact intramurally, intra-organically), however the third one implicates central (cerebral) activity which boomerangs back via centripetal and centrifugal connections. These levels likely compose synoptic ternary reflex set system which may be validated in future studies. To hypothesize, coordinated mutual reciprocity of reflex activity results in stabilization of heart rhythm in robust heart. Any stressful cardiac event may lead to the shift of the rhythm toward unfavorable clinical entity probably via the loss of the influence of dominant reflex. Overall, an interaction and likely intrinsic inter-tiered competition along with possible interplay between physiological and pathological reflexes may be treated as contributing factors for the inception and maintaining of arrhythmias and cardiac performance as well. These assumptions await further documentation. If such a tenet were recognized, the changes in the clinical approach to arrhythmia management might be anticipated, preferably by selective reflex suppression or activation strategy.

Keywords: Automaticity; Autonomic Control; Cardiovascular Reflexes; Mechanically-Induced Arrhythmias; Reflex Control; Ternary Reflex System

References

  1. Cardiovasc Res. 1996 Jul;32(1):52-61 - PubMed
  2. Braz J Med Biol Res. 1998 Jul;31(7):863-88 - PubMed
  3. Eur Heart J. 1995 Jun;16(6):818-24 - PubMed
  4. Indian Pacing Electrophysiol J. 2010 Aug 15;10(8):357-71 - PubMed
  5. Auton Neurosci. 2006 Jun 30;126-127:355-70 - PubMed
  6. Proc Natl Acad Sci U S A. 1979 Aug;76(8):4146-50 - PubMed
  7. Arch Neurol. 1967 Oct;17(4):441-5 - PubMed
  8. Acta Physiol Scand. 1987 Jun;130(2):177-85 - PubMed
  9. J Am Coll Cardiol. 1998 Dec;32(7):1891-9 - PubMed
  10. Am J Cardiovasc Dis. 2013;3(1):1-16 - PubMed
  11. Heart Rhythm. 2015 Nov;12(11):2294-5 - PubMed
  12. J Pediatr Neurosci. 2011 Jul;6(2):144-5 - PubMed
  13. Circulation. 2002 Oct 8;106(15):1906-8 - PubMed
  14. Lancet. 1993 Sep 18;342(8873):740 - PubMed
  15. Brain Res. 2003 Oct 17;987(2):214-22 - PubMed
  16. Organogenesis. 2013 Jul-Sep;9(3):176-93 - PubMed
  17. Cold Spring Harb Symp Quant Biol. 1965;30:59-68 - PubMed
  18. Biomed Res Int. 2014;2014:478965 - PubMed
  19. Physiol Rev. 2014 Apr;94(2):609-53 - PubMed
  20. J Anat. 1999 Oct;195 ( Pt 3):359-73 - PubMed
  21. Circ Res. 2010 Jan 8;106(1):185-92 - PubMed
  22. PLoS One. 2014 Oct 07;9(10):e109754 - PubMed
  23. Prog Cardiovasc Dis. 2008 May-Jun;50(6):404-19 - PubMed
  24. Chest. 1971 Mar;59(3):335-8 - PubMed
  25. Circulation. 1990 Aug;82(2 Suppl):I103-13 - PubMed
  26. Am Heart J. 1959 Jul;58(1):59-70 - PubMed
  27. Saudi J Anaesth. 2014 Jan;8(1):138-9 - PubMed
  28. Auton Neurosci. 2001 Jul 20;90(1-2):66-75 - PubMed
  29. Community Eye Health. 2012;25(79-80):58-9 - PubMed
  30. Card Electrophysiol Clin. 2011 Mar 1;3(1):23-45 - PubMed
  31. Physiol Rev. 2011 Jan;91(1):265-325 - PubMed
  32. Heart Rhythm. 2015 Oct;12 (10 ):2115-24 - PubMed
  33. Circ Res. 1981 Jul;49(1):1-15 - PubMed
  34. Circ Res. 1992 Oct;71(4):898-905 - PubMed
  35. J Am Soc Nephrol. 1996 Jul;7(7):1079-84 - PubMed
  36. Chest. 1985 Aug;88(2):190-3 - PubMed
  37. Anesth Analg. 2012 Mar;114(3):520-32 - PubMed
  38. J Atr Fibrillation. 2015 Aug 31;8(2):1216 - PubMed
  39. Rev Esp Cardiol (Engl Ed). 2012 Feb;65(2):174-85 - PubMed
  40. Circulation. 2001 Nov 6;104(19):2324-30 - PubMed
  41. Physiol Rev. 2008 Jul;88(3):919-82 - PubMed

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