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T he vagus and sympathetic nerves link the heart to the central nervous system, carrying information from the heart over neural afferents and to the heart over neural efferents. Although it is generally well accepted that the autonomic nervous system can promote, precipitate, or prevent the development of cardiac arrhythmias, the mechanisms by which this transpires are incompletely understood. Several excellent recent reviews provide an overall discussion of the role of the autonomic nervous system and the genesis of cardiac arrhythmias.12 This review will focus on selected recent observations concerning autonomic innervation of the heart, the effects of myocardial ischemia and infarction on such innervation, and how some of these changes can modulate the development of cardiac arrhythmias.

Influence of myocardial ischemia and infarction on autonomic innervation of heart.