Mechanisms Underlying Antiarrhythmic Properties of Cardioprotective Agents Impacting Inflammation and Oxidative Stress

Int J Mol Sci. 2022 Jan 26;23(3):1416. doi: 10.3390/ijms23031416.


The prevention of cardiac life-threatening ventricular fibrillation and stroke-provoking atrial fibrillation remains a serious global clinical issue, with ongoing need for novel approaches. Numerous experimental and clinical studies suggest that oxidative stress and inflammation are deleterious to cardiovascular health, and can increase heart susceptibility to arrhythmias. It is quite interesting, however, that various cardio-protective compounds with antiarrhythmic properties are potent anti-oxidative and anti-inflammatory agents. These most likely target the pro-arrhythmia primary mechanisms. This review and literature-based analysis presents a realistic view of antiarrhythmic efficacy and the molecular mechanisms of current pharmaceuticals in clinical use. These include the sodium-glucose cotransporter-2 inhibitors used in diabetes treatment, statins in dyslipidemia and naturally protective omega-3 fatty acids. This approach supports the hypothesis that prevention or attenuation of oxidative and inflammatory stress can abolish pro-arrhythmic factors and the development of an arrhythmia substrate. This could prove a powerful tool of reducing cardiac arrhythmia burden.

Keywords: SGLT2i; cardiac arrhythmias; inflammation; omega-3; oxidative stress; statins.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / pharmacology
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation* / drug therapy
  • Cardiotonic Agents / pharmacology
  • Cardiotonic Agents / therapeutic use
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Inflammation / drug therapy
  • Oxidative Stress
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use


  • Anti-Arrhythmia Agents
  • Cardiotonic Agents
  • Sodium-Glucose Transporter 2 Inhibitors