Anatomy and Physiology of Intrinsic Cardiac Autonomic Nervous System

Following demonstration that the intrinsic cardiac nervous system (ICNS) is a potential modulator of the initiation and perpetuation of atrial fibrillation and the major reason for several bradyarrhythmias, catheter-based autonomic modulation emerged as a novel therapy in recent years (1,2). The anatomy and physiology of the ICNS are relevant to the cardiac electrophysiologist because this invisible anatomic structure is becoming an important target during radiofrequency catheter ablation.