Oxidative stress and atrial fibrillation: an update

Abstract

Atrial remodelling involves electrophysiological and structural abnormalities that promote the development and perpetuation of atrial fibrillation. Experimental and clinical data indicate that oxidative stress is implicated in the pathophysiology of atrial remodelling. The mechanistic links between atrial remodelling and oxidative stress are complex with several underlying diseases and conditions may affect these pathways. Therefore, the development of antioxidant interventions in this setting remains difficult. Besides classical antioxidant compounds, several agents with pleiotropic effects, including anti-inflammatory and antioxidant, have been tested in experimental and clinical settings with variable results. Strategies applying conventional antioxidants in specific situations such as postoperative atrial fibrillation show beneficial effects, especially the two-step regimen of antioxidants combination. Of note, there are limited data on the development of strategies that target specific sources of reactive oxygen species implicated in atrial remodelling. Lifestyle, diet, and risk factors modification is a complementary promising approach. This updated review provides a concise and critical overview of all available data regarding oxidative stress and its modulation in atrial fibrillation. Future directions on this exciting field are also discussed.

Keywords:

• Antioxidants
• atrial fibrillation
• atrial remodelling
• oxidative stress
• reactive oxygen species

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Funding

This work was supported by grants [81570298, 81270245 to T.L.] from the National Natural Science Foundation of China, Tianjin Natural Science Foundation [16JCZDJC34900 to T.L.].