Iron and atrial fibrillation: A review

Area of Science:

• Cardiology
• Biochemistry
• Molecular Medicine

Background:

• Atrial fibrillation (AF) is a common arrhythmia linked to significant cardiovascular risks.
• The precise causes of AF remain unclear, but emerging evidence points to iron metabolism disruptions.
• Abnormal iron handling in heart cells can create pro-arrhythmic conditions.

Purpose of the Study:

• To review the mechanisms linking atrial iron dysregulation to AF.
• To explore the consequences of altered iron metabolism on cardiac function.
• To discuss therapeutic strategies targeting iron metabolism in AF.

Main Methods:

• Literature review of recent studies on iron metabolism and AF.
• Analysis of proposed mechanisms involving iron, calcium, ion channels, and oxidative stress.
• Examination of therapeutic interventions in preclinical and clinical settings.

Main Results:

• Disordered iron metabolism in cardiomyocytes promotes AF through calcium mishandling, ion channel remodeling, and oxidative stress.
• Iron overload in AF patients is associated with ferroptosis, a regulated cell death pathway.
• Interventions like iron chelators and ferroptosis inhibitors show promise in preventing AF.

Conclusions:

• Altered atrial iron handling is a significant factor in AF pathophysiology.
• Targeting iron metabolism and ferroptosis presents a novel therapeutic avenue for AF.
• Further research is warranted to fully elucidate the role of iron in AF and optimize treatments.