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Innervation of the heart

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Innervation of the heart includes the afferent (sensory) neurons (green) that transmit information from baroreceptors in the heart to the spinal cord and brain, and efferent (motor) neurons that innervate the heart. These efferent motor neurons comprise the cardiac autonomic nervous system and include the sympathetic (purple) and parasympathetic (yellow) neurons. Depending on the location of neuronal cell bodies of each neuron type, cardiac innervation is divided into intrinsic and extrinsic elements. Intracardiac vagal innervation (pink) originates in the brain and relays information into the heart, whereas vagal neurons (yellow) synapse with secondary interneurons (pink) to activate the parasympathetic tone. The cell bodies of interconnecting neurons and other neural elements all cluster into the ganglionated plexi (small dark dots) in specific cardiac locations with diverse densities.

Abbreviations: Ao, aorta; IVC, inferior vena cava; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; SVC, superior cava.

(Source: Yarkoni M, Rehman WU, Bajwa A, Yarkoni A, Rehman AU. Ganglionated plexus ablation procedures to treat vasovagal syncope. Int J Mol Sci 2023;24[17]:13264. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)