{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:42:06Z","timestamp":1789663326609,"version":"4.0.1"},"reference-count":185,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["3OT2OD023848"],"award-info":[{"award-number":["3OT2OD023848"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UO1EB025138"],"award-info":[{"award-number":["UO1EB025138"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>Dysfunction of the autonomic nervous system has been implicated in the pathogenesis of cardiovascular disease, including congestive heart failure and cardiac arrhythmias. Despite advances in the medical and surgical management of these entities, progression of disease persists as does the risk for sudden cardiac death. With improved knowledge of the dynamic relationships between the nervous system and heart, neuromodulatory techniques such as cardiac sympathetic denervation and vagal nerve stimulation (VNS) have emerged as possible therapeutic approaches for the management of these disorders. In this review, we present the structure and function of the cardiac nervous system and the remodeling that occurs in disease states, emphasizing the concept of increased sympathoexcitation and reduced parasympathetic tone. We review preclinical evidence for vagal nerve stimulation, and early results of clinical trials in the setting of congestive heart failure. Vagal nerve stimulation, and other neuromodulatory techniques, may improve the management of cardiovascular disorders, and warrant further study.<\/jats:p>","DOI":"10.3389\/fphys.2020.617459","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T03:50:46Z","timestamp":1608609046000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":145,"title":["Autonomic Modulation for Cardiovascular Disease"],"prefix":"10.3389","volume":"11","author":[{"given":"Joseph","family":"Hadaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Ardell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.brs.2012.09.013","article-title":"Vagus nerve stimulation therapy randomized to different amounts of electrical charge for treatment-resistant depression: acute and chronic effects","volume":"6","author":"Aaronson","year":"2013","journal-title":"Brain Stimul."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1001\/jamacardio.2019.4717","article-title":"Coronary sinus neuropeptide Y levels and adverse outcomes in patients with stable chronic heart failure","volume":"5","author":"Ajijola","year":"2019","journal-title":"JAMA Cardiol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e94715","DOI":"10.1172\/jci.insight.94715","article-title":"Inflammation, oxidative stress, and glial cell activation characterize stellate ganglia from humans with electrical storm","volume":"2","author":"Ajijola","year":"2017","journal-title":"JCI Insight"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"H579","DOI":"10.1152\/ajpheart.00754.2012","article-title":"Functional differences between junctional and extrajunctional adrenergic receptor activation in mammalian ventricle","volume":"304","author":"Ajijola","year":"2013","journal-title":"Am. 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