Methods that reduce autonomic innervation or outflow have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias.^2–6 The latter studies suggest that neuromodulation may be helpful in controlling atrial fibrillation.

Chen et al. (2014) published a review of the relationship between the autonomic nervous system and the pathophysiology of AF and the potential benefit and limitations of neuromodulation in the management of this arrhythmia that is beyond the scope of this paper.

I am optimistic that the neuroregulation derived from EEG neurofeedback may be a mitigating treatment for both autonomic dysfunction and greater self-regulation and abstinence from substance use. The role of the autonomic nervous system in atrial fibrillation is multifactorial and alcohol induces atriogenic changes are powerful – including the potential for cardiac remodeling. “Autonomic nervous system activation can induce significant and heterogeneous changes of atrial electrophysiology and induce atrial tachyarrhythmias, including atrial tachycardia and atrial fibrillation (AF).” The importance of the autonomic nervous system in atrial arrhythmogenesis is also supported by circadian variation in the incidence of symptomatic AF in humans in Chen et al., 2014. I am working on a protocol using biofeedback and mindfulness to mitigate the autonomic underpinnings of arrhythmias in hope of making a positive impact on recovery from AF-related stroke. There is a peer reviewed literature for using neurofeedback for reducing the craving for alcohol that may be matched with paced breathing and heart rate variability which can activate parasympathetic pathways and modify baroreceptor response and its multifactorial impact on health described in this paper.

References

Center for Behavioral Health Statistics and Quality. Behavioral Health Trends in the United States: Results From the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Available at: http://www.samhsa.gov/data. Accessed January 25, 2021

Steinbigler, P Haberl, R. König, B. et al. (2003) P-wave signal averaging identifies patients prone to alcohol-induced paroxysmal atrial fibrillationAm J Cardiol, 91, pp. 491-494

Voskoboinik, A et al. (2016). Alcohol and Atrial Fibrillation: A Sobering Review. J of Amer College of Cardiology, Volume 68, Issue 23, 13 December 2016, Pages 2567-2576.

O’Keefe, J, DiNicolantonio, D.J. Alcohol and Atrial Fibrillation Journal of the American College of Cardiology, Volume 69, Issue 20, 23 May 2017, Pages 2578

Chen, P, Chen, L, Fishbein, M, Lin, S-F, and Nattel, S (2014). Role of the Autonomic Nervous System in Atrial Fibrillation: pathophysiology and therapy. Circulation Research, Volume 114, Issue 9, 25, Pages 1500-1515

Viskin S, Golovner M, Malov N, Fish R, Alroy I, Vila Y, Laniado S, Kaplinsky E, Roth A. (1999). Circadian variation of symptomatic paroxysmal atrial fibrillation. Data from almost 10,000 episodes. Eur Heart Journal; 20:1429–1434.