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European Heart Journal Advance Access published online on November 8, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi645
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received May 18, 2005
Revised July 28, 2005
Accepted October 20, 2005

Review

Is atrial fibrillation an inflammatory disorder?

Christopher J. Boos 1, Richard A. Anderson 2, and Gregory Y.H. Lip 1*

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

* To whom correspondence should be addressed.
Gregory Y.H. Lip, E-mail: g.y.h.lip{at}bham.ac.uk


  Abstract

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.

Keywords: Atrial fibrillation; Inflammation; Angiotensin II; Prevention; Novel therapies.
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