Program in Neurocardiology

Sudden cardiac death is the leading cause of death in the United States and accounts for almost 250,000 deaths/year. The vast majority of these deaths are thought to be due to ventricular tachyarrhythmias. Several cellular and molecular events that underlie sudden arrhythmic death have been well characterized. A major challenge in the field of cardiac electrophysiology is to understand how events at a cellular and molecular level translate into behavior of arrhythmias in the whole organ. The autonomic nervous system is a powerful regulator of arrhythmias. Specifically heightened sympathetic activity has well-known proarrhythmic consequences, including increased ventricular ectopy, decreased ventricular fibrillation threshold, and increased inherent dynamic instability of cardiac wave propagation. However, the electrophysiological mechanisms that underlie such regulation are not well understood. Our group investigates regulation of sympathetic output to the heart at the level of the stellate ganglia and the spinal cord. Electrophysiological effects in normal and diseased myocardium are the focus of our studies. We perform direct stimulation and blockade of sympathetic nerves that supply the heart. In the intermediate to long term, understanding neruraxial modulation has the potential to develop novel low cost therapies for the prevention of sudden cardiac death.

Mission: To develop a deeper understanding of the neurobiology of cardiac arrhythmias and brain-heart interactions. Studies are directed toward determining basic mechanisms of neuraxial regulation of cardiac excitability and its changes in pathophysiological states.

Disease areas: Sudden cardiac death, ventricular tachycardia, ventricular fibrillation, atrial arrhythmias, neural perception of cardiac rhythms

Key investigators: Kalyanam Shivkumar MD PhD, Marmar Vaseghi MD, Aman Mahajan MD PhD, Olujimi Ajijola MD, Rafael Ramirez PhD

Funding: NHLBI, AHA

Director: Kalyanam Shivkumar, MD, PhD

UCLA interactions: CNS Program in Mind Body Research, UCLA Cardiac Arrhythmia Center, Department of Anesthesiology, Cardiac Surgery