Gut microbiota and cardiac arrhythmia

Front Cell Infect Microbiol. 2023 Apr 25:13:1147687. doi: 10.3389/fcimb.2023.1147687. eCollection 2023.


One of the most prevalent cardiac diseases is cardiac arrhythmia, however the underlying causes are not entirely understood. There is a lot of proof that gut microbiota (GM) and its metabolites have a significant impact on cardiovascular health. In recent decades, intricate impacts of GM on cardiac arrythmia have been identified as prospective approaches for its prevention, development, treatment, and prognosis. In this review, we discuss about how GM and its metabolites might impact cardiac arrhythmia through a variety of mechanisms. We proposed to explore the relationship between the metabolites produced by GM dysbiosis including short-chain fatty acids(SCFA), Indoxyl sulfate(IS), trimethylamine N-oxide(TMAO), lipopolysaccharides(LPS), phenylacetylglutamine(PAGln), bile acids(BA), and the currently recognized mechanisms of cardiac arrhythmias including structural remodeling, electrophysiological remodeling, abnormal nervous system regulation and other disease associated with cardiac arrythmia, detailing the processes involving immune regulation, inflammation, and different types of programmed cell death etc., which presents a key aspect of the microbial-host cross-talk. In addition, how GM and its metabolites differ and change in atrial arrhythmias and ventricular arrhythmias populations compared with healthy people are also summarized. Then we introduced potential therapeutic strategies including probiotics and prebiotics, fecal microbiota transplantation (FMT) and immunomodulator etc. In conclusion, the GM has a significant impact on cardiac arrhythmia through a variety of mechanisms, offering a wide range of possible treatment options. The discovery of therapeutic interventions that reduce the risk of cardiac arrhythmia by altering GM and metabolites is a real challenge that lies ahead.

Keywords: GM; cardiac arrhythmia; mechanism; metabolites; review.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac
  • Dysbiosis / therapy
  • Fecal Microbiota Transplantation
  • Gastrointestinal Microbiome* / physiology
  • Humans
  • Prebiotics
  • Probiotics* / therapeutic use


  • Prebiotics

Grants and funding

This work was supported by National Natural Science Foundation of China (grant number 82270494)--BL and Shanxi Graduate Education Innovation Project (grant number 2022Y386)--HF.