Oxidative stress: a possible pathogenesis of atrial fibrillation

Atrial fibrillation (AF) is the most commonly sustained arrhythmia in clinical practice. Despite the extensive studies, the pathophysiology of AF, however, remains incompletely understood. Studies have demonstrated that oxidative stress may be involved in cardiac structural and electrical remodeling. More recently, a growing body of evidence suggests that oxidative stress is associated with the development of AF. The evidence for the hypotheses included that: (1) histological studies have demonstrated oxidative damage in both AF patients and animal models of AF; (2) oxidative stress markers are increased in AF patients, and are associated with the presence of AF; (3) drugs that have antioxidant properties show beneficial effects on AF development. Although the studies suggest the association between oxidative stress and AF, the exact pathogenesis of oxidative stress in AF development remains elusive and requires further investigation. Specifically, the causality between oxidative stress and AF; the levels of the oxidative stress in various types of AFs and their role in the pathogenesis of AF; the effects of strategies to reduce oxidative stress on atrial structural and electrical remodeling, and their exact role in the development of AF. Oxidative stress may provide a scientific basis for further research on the underlying mechanisms of AF and may target for pharmacological interruption of AF.