Neural Control of the Heart

  • Matthew N. Levy
  • Paul J. Martin
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 34)


The various structures in the heart are regulated by both divisions of the autonomic nervous system. The sympathetic division exerts facilitatory effects, whereas the parasympathetic has an inhibitory influence. The central nervous system controls the relative levels of sympathetic and vagal activity, usually in a reciprocal fashion; that is, as sympathetic activity is increased, parasympathetic activity is usually diminished, and vice versa. In certain regions of the heart, such as the nodal tissues, parasympathetic effects tend to predominate over sympathetic influences. In other regions, however, such as the ventricular myocardium, the effects of the sympathetic division are usually much greater than those of the parasympathetic division. When both divisions are active simultaneously, the sympathetic and vagal effects are usually not additive in a simple, algebraic fashion, but the sympathetic—parasympathetic interactions tend to be highly nonlinear.


Vagal Stimulation Vagal Activity Inotropic Response Cardiac Sympathetic Nerve Chronotropic Response 
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  1. 1.
    Randall WC: Neural regulation of the heart. New York: Oxford University, 1977.Google Scholar
  2. 2.
    Levy MN, Martin PJ: Neural control of the heart. In: Berne RM (ed) Handbook of physiology. Sect 2: Cardiovascular system. Vol 1: The heart. Bethesda MD: American Physiological Society, 1979, pp 581–620.Google Scholar
  3. 3.
    Levy MN, Martin PJ: Neural control of heart rate and atrioventricular conduction. In: Abboud FM, Fozzard HA, Gilmore JP, Reis DJ (eds) Disturbances in neurogenic control of the circulation. Bethesda MD: American Physiological Society, 1981, pp 205–216.Google Scholar
  4. 4.
    Higgins CB, Vatner SF, Braunwald E: Parasympathetic control of the heart. Pharmacol Rev 25: 120–155, 1973.Google Scholar
  5. 5.
    Duchêne-Marullaz P, Arnould P, Schaff G, Lavarenne J, Billaud J: Comparaison des effets chrono-trope, inotrope et dromotrope de l’excitation du stellaire droit chez le chien chloralosé. C R Soc Biol (Paris) 160: 1586–1589, 1966.Google Scholar
  6. 6.
    Loffelholz K: Release of acetylcholine in the isolated heart. Am J Physiol 240: H431 - H440, 1981.PubMedGoogle Scholar
  7. 7.
    Watanabe AM, Jones LR, Manalan AS, Besch HR Jr: Cardiac autonomic receptors: recent concepts from radiolabeled ligand-binding studies. Circ Res 50: 161–174, 1982.PubMedCrossRefGoogle Scholar
  8. 8.
    Mizeres MJ: The origin and course of the cardioac celerator fibers in the dog. Anat Rec 132: 261–279, 1958.PubMedCrossRefGoogle Scholar
  9. 9.
    Spyer KM: Baroreceptor control of vagal preganglionic activity. In: Brooks CM, Koizimi K, Sato A (eds) Integrative functions of the autonomic nervous system. Tokyo: University of Tokyo, 1979, pp 283–292.Google Scholar
  10. 10.
    Weiss GK, Priola DV: Brainstem sites for activation of vagal cardioaccelerator fibers in the dog. Am J Physiol 223: 300–304, 1972.PubMedGoogle Scholar
  11. 11.
    Noble D: The initiation of the heartbeat. Oxford: Clarendon, 1979.Google Scholar
  12. 12.
    Warner HR, Cox A: A mathematical model of heart rate control by sympathetic and vagus efferent information. J Appl Physiol 17: 349–355, 1962.PubMedGoogle Scholar
  13. 13.
    Axelrod J, Weinshilboum R: Catecholamines. N Engl J Med 287: 237–242, 1972.PubMedCrossRefGoogle Scholar
  14. 14.
    Matsuda Y, Masuda Y, Levy MN: The effects of cocaine and metanephrine on the cardiac responses to sympathetic nerve stimulation in dogs. Circ Res 45: 180–187, 1979.PubMedCrossRefGoogle Scholar
  15. 15.
    Matsuda Y, Masuda Y, Blattberg B, Levy MN: The effects of cocaine, chlorpheniramine and tripelennamine on the cardiac responses to sympathetic nerve stimulation. Eur J Pharmacol 63: 25–33, 1980.PubMedCrossRefGoogle Scholar
  16. 16.
    Rosenblueth A: The chemical mediation of autonomic nervous impulses as evidenced by summation of responses. Am J Physiol 102: 12–38, 1932.Google Scholar
  17. 17.
    Levy MN, Ng ML, Zieske H: Functional distribution of the peripheral cardiac sympathetic pathways. Circ Res 19: 650–661, 1966.PubMedCrossRefGoogle Scholar
  18. 18.
    Randall WC, McNally H, Cowan J, Caliguiri L, Rohse WG: Functional analysis of the cardioaugmentor and cardioaccelerator pathways in the dog. Am J Physiol 191: 213–217, 1957.PubMedGoogle Scholar
  19. 19.
    Randall WC, Priola DV, Ulmer RH: A functional study of the distribution of cardiac sympathetic nerves. Am J Physiol 205: 1227–1231, 1963.PubMedGoogle Scholar
  20. 20.
    James TN, Spence CA: Distribution of cholinesterase within the sinus node and AV node of the human heart. Anat Rec 155: 151–162, 1966.PubMedCrossRefGoogle Scholar
  21. 21.
    Brown GL, Eccles JE: The action of a single vagal volley on the rhythm of the heart beat. J Physiol (Lond) 82: 211–240, 1934.Google Scholar
  22. 22.
    Levy MN, Martin PJ, Iano T, Zieske H: Effects of single vagal stimuli on heart rate and atrioventricular conduction. Am J Physiol 218: 1256–1262, 1970.PubMedGoogle Scholar
  23. 23.
    Iano TL, Levy MN, Lee MH: An acceleratory component of the parasympathetic control of heart rate. Am J Physiol 224: 997–1005, 1973.Google Scholar
  24. 24.
    Jalife J, Moe GK: Phasic effects of vagal stimulation on pacemaker activity of the isolated sinus node of the young cat. Circ Res 45: 595–608, 1979.PubMedCrossRefGoogle Scholar
  25. 25.
    Spear JF, Kronhaus KD, Moore EN, Kline RP: The effect of brief vagal stimulation on the isolated rabbit sinus node. Circ Res 44: 75–88, 1979.PubMedCrossRefGoogle Scholar
  26. 26.
    Hutter OF: Mode of action of autonomic transmitters on the heart. Br Med Bull 13: 176–180, 1957.PubMedGoogle Scholar
  27. 27.
    Reid JVO: The cardiac pacemaker: effects of regularly spaced nervous input. Am Heart J 78: 58–64, 1969.PubMedCrossRefGoogle Scholar
  28. 28.
    Levy MN, Martin PJ, lano T, Zieske H: Paradoxical effect of vagus nerve stimulation on heart rate in dogs. Circ Res 25: 303–314, 1969.PubMedCrossRefGoogle Scholar
  29. 29.
    Levy MN, lano T, Zieske H: Effects of repetitive bursts of vagal activity on heart rate. Circ Res 30: 186–195, 1972.PubMedCrossRefGoogle Scholar
  30. 30.
    Dong E Jr, Reitz BA: Effect of timing of vagal stimulation on heart rate in the dog. Circ Res 27: 635–646, 1970.PubMedCrossRefGoogle Scholar
  31. 31.
    James TN: The sinus node as a servomechanism. Circ Res 32: 307–313, 1973.PubMedCrossRefGoogle Scholar
  32. 32.
    Hariman RJ, Hoffman RB, Naylor RE: Electrical activity from the sinus node region in conscious dogs. Circ Res 47: 755–791, 1980.CrossRefGoogle Scholar
  33. 33.
    Levy MN: Sympathetic—parasympathetic interactions in the heart. Circ Res 29: 437–445, 1971.PubMedCrossRefGoogle Scholar
  34. 34.
    Levy MN, Zieske H: Autonomic control of cardiac pacemaker activity and atrioventricular transmission. J Appl Physiol 27: 465–470, 1969.PubMedGoogle Scholar
  35. 35.
    Stuesse SL, Wallick DW, Levy MN: Autonomic control of right atrial contractile strength in the dog. Am J Physiol 236: H860 - H865, 1979.PubMedGoogle Scholar
  36. 36.
    Levy MN, Ng M, Martin P, Zieske H: Sympathetic and parasympathetic interactions upon the left ventricle of the dog. Circ Res 19: 5–10, 1966.CrossRefGoogle Scholar
  37. 37.
    Levy MN, Blattberg B: Effect of vagal stimulation on the overflow of norepinephrine into the coronary sinus during cardiac sympathetic nerve stimulation in the dog. Cir Res 38: 81–85, 1976.CrossRefGoogle Scholar
  38. 38.
    Levy MN: Neural control of the heart: sympathetic—vagal interactions. In: Baan J, Noordergraaf A, Raines J (eds) Cardiovascular system dynamics. Cambridge: MIT, 1978, pp 365–370.Google Scholar
  39. 39.
    Muscholl E: Peripheral muscarinic control of norepinephrine release in the cardiovascular system. Am J Physiol 239: H713 - H720, 1980.PubMedGoogle Scholar
  40. 40.
    Lavallée M, De Champlain J, Nadeau RA, Yamaguchi N: Muscarinic inhibition of endogenous myocardial catecholamine liberation in the dog. Can J Physiol Pharmacol 56: 642–649, 1978.PubMedCrossRefGoogle Scholar
  41. 41.
    Mancia G, Bonazzi O, Pozzoni L, Ferrari A, Gardumi M, Gregorini L, Perondi R: Baroreceptor control of atrioventricular conduction in man. Circ Res 44: 752–758, 1979.PubMedCrossRefGoogle Scholar
  42. 42.
    Borst C, Karemaker JM, Danning AJ: Prolongation of atrioventricular conduction time by electrical stimulation of the carotid sinus nerves in man. Circulation 65: 432–434, 1982.PubMedCrossRefGoogle Scholar
  43. 43.
    Hageman GR, Randall WC, Armour JA: Direct and reflex cardiac bradydysrhythmias from small vagal nerve stimulations. Am Heart J 89: 338–348, 1975.PubMedCrossRefGoogle Scholar
  44. 44.
    Prystowsky EN, Jackman WM, Rinkenberger RL, Heger JJ, Zipes DP: Effect of autonomic blockade on ventricular refractoriness and atrioventricular nodal conduction in humans. Circ Res 49: 511–518, 1981.PubMedCrossRefGoogle Scholar
  45. 45.
    Spear JF, Moore EN: Influence of brief vagal and stellate nerve stimulation on pacemaker activity and conduction within the atrioventricular conduction system of the dog. Circ Res 32: 27–41, 1973.PubMedCrossRefGoogle Scholar
  46. 46.
    Martin PJ: Dynamic vagal control of atrial—ventricular conduction: theoretical and experimental stud. ies. Ann Biomed Eng 3: 275–295, 1975.PubMedCrossRefGoogle Scholar
  47. 47.
    Zipes DP, Mihalick MJ, Robbins GT: Effects of selective vagal and stellate ganglion stimulation on atrial refractoriness. Cardiovasc Res 8: 647–655, 1974.PubMedCrossRefGoogle Scholar
  48. 48.
    Cagin NA, Kunstadt D, Wolfish P, Levitt B: The influence of heart rate on the refractory period of the atrium and A-V conducting system. Am Heart J 85: 358–366, 1973.CrossRefGoogle Scholar
  49. 49.
    Schwartz PJ, Verrier RL, Lown B: Effect of stellectomy and vagotomy on ventricular refractoriness in dogs. Circ Res 40: 536–540, 1977.PubMedCrossRefGoogle Scholar
  50. 50.
    Vallin HO: Autonomous influence on sinus node and AV node function in the elderly without significant heart disease: assessment with electrophysiological and autonomic tests. Cardiovasc Res 14: 206–216, 1980.PubMedCrossRefGoogle Scholar
  51. 51.
    Martins JB, Zipes DP: Effects of sympathetic and vagal nerves on recovery properties of the endocardium and epicardium of the canine left ventricle. Circ Res 46: 100–110, 1980.PubMedCrossRefGoogle Scholar
  52. 52.
    Kolman BS, Verrier RL, Lown B: Effect of vagus nerve stimulation upon excitability of the canine ventricle: role of sympathetic—parasympathetic interactions. Am J Cardiol 37: 1041–1045, 1976.PubMedCrossRefGoogle Scholar
  53. 53.
    Blair RW, Shimizu T, Bishop VS: The role of vagal afferents in the reflex control of the left ventricular refractory period in the cat. Circ Res 46: 378–386, 1980.PubMedCrossRefGoogle Scholar
  54. 54.
    Waxman MB, Wald RW: Termination of ventricular tachycardia by an increase in cardiac vagal drive. Circulation 56: 385–391, 1977.PubMedCrossRefGoogle Scholar
  55. 55.
    De Geest H, Levy MN, Zieske H, Lipman RI: Depression of ventricular contractility by stimulation of the vagus nerves. Circ Res 17: 222–235, 1965.CrossRefGoogle Scholar
  56. 56.
    Randall WC, Wechsler JB, Pace JB, Szentivanyi M: Alterations in myocardial contractility during stimulation of the cardiac nerves. Am J Physiol 214: 1205–1212, 1968.PubMedGoogle Scholar
  57. 57.
    Wiggers CJ: The physiology of the mammalian auricle. II. The influence of the vagus nerves on the fractionate contraction of the right auricle. Am J Physiol 42: 133–140, 1917.Google Scholar
  58. 58.
    Sarnoff SJ, Brockman SK, Gilmore JP, Linden RJ, Mitchell JH: Regulation of ventricular contraction: influence of cardiac sympathetic and vagal nerve stimulation on atrial and ventricular dynamics. Circ Res 8: 1108–1122, 1960.PubMedCrossRefGoogle Scholar
  59. 59.
    Randall WC, Armour JA: Complex cardiovascular responses to vagosympathetic stimulation. Proc Soc Exp Biol Med 145: 493–499, 1974.PubMedGoogle Scholar
  60. 60.
    Martin P: Atrial inotropic responses to brief vagal stimuli: frequency—force interactions. Am J Physiol 239: H333 - H341, 1980.PubMedGoogle Scholar
  61. 61.
    Martin P, Levy MN, Matsuda Y: Fade of the cardiac responses during tonic vagal stimulation. Am J Physiol 243: H219 - H225, 1982.PubMedGoogle Scholar
  62. 62.
    Loeb JM, Dalton DP, Moran JM: Sensitivity differences of SA and AV node to vagal stimulation: attenuation of vagal effects at SA node. Am J Physiol 241: H684 - H690, 1981.PubMedGoogle Scholar
  63. 63.
    Jalife J, Hamilton AJ, Moe GK: Desensitization of the cholinergic receptor at the sinoatrial cell of the kitten. Am J Physiol 238: H439 - H448, 1980.PubMedGoogle Scholar
  64. 64.
    Korner PI: Central nervous control of autonomic cardiovascular function. In: Berne RM (ed) Handbook of physiology. Sect 2: The cardiovascular system. Vol 1: The heart. Bethesda MD: American Physiological Society, 1979, pp 691–739.Google Scholar
  65. 65.
    Kirchheim HR: Systemic arterial baroreceptor reflexes. Physiol Rev 56: 100–176, 1976.PubMedGoogle Scholar
  66. 66.
    Brown AM: Cardiac reflexes. In: Berne, RM (ed) Handbook of physiology. Sect 2: Cardiovascular system. Vol 1. Washington DC: American Physiological Society, 1979, pp 677–690.Google Scholar
  67. 67.
    Coleridge JCG, Coleridge HM: Chemoreflex regulation of the heart. In: Berne, RM (ed) Handbook of physiology. Sect 2: Cardiovascular system. Vol 1. Washington DC: American Physiological Society, 1979, pp 653–676.Google Scholar
  68. 68.
    Downing SE: Baroreceptor regulation of the heart. In: Berne, RM (ed) Handbook of physiology. Sect 2: Cardiovascular system. Vol 1. Washington DC: American Physiological Society, 1979, pp 621–652.Google Scholar
  69. 69.
    Bainbridge FA: The influence of venous filling upon the rate of the heart. J Physiol (Lond) 50: 65–84, 1915.Google Scholar
  70. 70.
    Vatner SF, Boettcher DH: Regulation of cardiac output by stroke volume and heart rate in conscious dogs. Circ Res 42: 557–561, 1978.PubMedCrossRefGoogle Scholar
  71. 71.
    Daly MB, Angell James JE, Elsner R: Role of carotid-body chemoreceptors and their reflex interactions in bradycardia and cardiac arrest. Lancet 1: 764–767, 1979.PubMedCrossRefGoogle Scholar
  72. 72.
    Berk JL, Levy MN: Profound reflex bradycardia produced by transient hypoxia or hypercapnia in man. Eur Surg Res 9: 75–84, 1977.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • Matthew N. Levy
  • Paul J. Martin

There are no affiliations available

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