Iron and atrial fibrillation: A review

Pacing Clin Electrophysiol. 2023 Apr;46(4):312-318. doi: 10.1111/pace.14678. Epub 2023 Mar 7.

Abstract

Atrial fibrillation (AF), one of the most common arrhythmias in clinical practice, is classified into paroxysmal, persistent, and permanent AF according to its duration. The development of AF is associated with increased cardiovascular morbidity and mortality. However, the exact etiology of this disease remains poorly understood. Recent studies found disorders of iron metabolism might be involved in the progression of AF. Abnormal iron metabolism in cardiomyocytes provides arrhythmogenic substrates through a variety of mechanisms, including calcium mishandling, ion channel remodeling, and oxidative stress overaction. Interestingly, in AF patients with iron overload, interventions on iron metabolism, such as iron chelators and ferroptosis inhibitors, has been shown to prevent AF via reducing ferroptosis. Herein, we review the possible mechanisms, consequences, and therapeutic implications of altered atrial iron handling for AF pathophysiology.

Keywords: atrial fibrillation; atrial remodeling; ferroptosis; iron overload.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation*
  • Atrial Remodeling*
  • Calcium / metabolism
  • Disease Progression
  • Heart Atria
  • Humans
  • Iron / therapeutic use

Substances

  • Iron
  • Calcium