Autonomic neural influences on the dysrhythmias resulting from myocardial infarction.

THE VAST majority of deaths associated with myocardial infarction occur within the first few hours of the acute attack and are secondary to ventricular dysrhythmias evolving to ventricular fibrillation. Although the precise mechanisms responsible for these lethal dysrhythmias remain elusive, a large body of data indicates that profound alterations in autonomic nervous system function occur during the early time interval. The purpose of this review is to: (1) examine the data obtained dealing with changes in autonomic activity during myocardial infarction; (2) present, when possible, the exact role exerted by each division of the autonomic nervous system; and (3) suggest areas of research that might be productive in further elucidation of the role of the autonomic nervous system in the development of dysrhythmias during myocardial infarction.