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Systematic review of biological therapies for atrial fibrillation

Callum McRae1, Anshul Kapoor1, Pushpinder Kanda1

  • 1Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

Heart Rhythm
|April 1, 2019
PubMed

Insights

Biological therapies targeting atrial fibrillation (AF) show significant promise in preclinical animal models. These novel treatments effectively reduce AF inducibility and atrial scarring, offering a new therapeutic avenue beyond traditional methods.

Area of Science:

  • Cardiovascular Research
  • Regenerative Medicine
  • Translational Science

Background:

  • Atrial fibrillation (AF) treatment paradigms are evolving beyond tissue ablation.
  • Novel therapeutic strategies focus on manipulating biological pathways underlying AF progression.
  • Preclinical evidence for biological approaches in AF treatment lacks systematic overview.

Purpose of the Study:

  • To systematically review and assess the preclinical evidence of biological therapies for AF treatment in animal models.
  • To determine the efficacy of biological approaches in reducing AF burden and improving atrial tissue health.
  • To evaluate the quality and potential bias in studies investigating biological treatments for AF.

Main Methods:

  • Systematic literature search using predefined terms for biological therapies in AF animal models.
  • Analysis of 25 retrieved studies focusing on primary efficacy outcomes.
  • Assessment of study quality and risk of bias in included preclinical research.

Main Results:

  • Biological therapies significantly reduced AF inducibility by 85% (OR 0.15, P < .01).
  • Atrial scar burden was reduced by 6.7% (P < .01), and days in sinus rhythm increased by 6.4 (P < .01).
  • Consistent positive effects were observed in both large and small animal models, with a slight trend towards higher bias in smaller animals.

Conclusions:

  • Biological therapies demonstrate significant efficacy in improving AF outcomes in preclinical animal models.
  • These therapies consistently reduce AF burden and atrial damage, irrespective of the specific biological mechanism targeted.
  • Biological approaches represent a promising novel treatment strategy for atrial fibrillation.
Keywords:
Animal modelsAtrial fibrillationCell therapyGene therapyTherapy

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