European Heart Journal

European Heart Journal Advance Access originally published online on November 8, 2005
European Heart Journal 2006 27(2):136-149; doi:10.1093/eurheartj/ehi645

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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Is atrial fibrillation an inflammatory disorder?

Christopher J. Boos¹, Richard A. Anderson² and Gregory Y.H. Lip^1,*

¹Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK
²University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK

Received 18 May 2005; revised 28 July 2005; accepted 20 October 2005; online publish-ahead-of-print 8 November 2005.

^* Corresponding author. Tel: +44 121 507 5080; fax: +44 121 554 4083. E-mail address: g.y.h.lip{at}bham.ac.uk

There is mounting evidence to support the influence of inflammation in the pathogenesis of atrial fibrillation (AF). Indeed, AF is associated with increased levels of known inflammatory markers, even after adjustment for confounding factors. The renin–angiotensin–aldosterone system (RAAS) appears to play a key role in this process. Atrial biopsies from patients with AF have also confirmed the presence of inflammation. Furthermore, there is preliminary evidence to support a number of drug therapies that have the potential to reduce the clinical burden of AF. In this review, we present an overview of the evidence supporting a link between inflammation and AF, and some of the drug therapies, such as the angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, steroids, fish oils, and vitamin C, that might be efficacious in the prevention of AF by modulating inflammatory pathways.

Key Words: Atrial fibrillation • Inflammation • Angiotensin II • Prevention • Novel therapies

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