Atrial fibrillation in the elderly: the potential contribution of reactive oxygen species

Abstract

Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia, and is a significant source of healthcare expenditures throughout the world. It is an arrhythmia with a very clearly defined predisposition for individuals of advanced age, and this fact has led to intense study of the mechanistic links between aging and AF. By promoting oxidative damage to multiple subcellular and cellular structures, reactive oxygen species (ROS) have been shown to induce the intra- and extra-cellular changes necessary to promote the pathogenesis of AF. In addition, the generation and accumulation of ROS have been intimately linked to the cellular processes which underlie aging. This review begins with an overview of AF pathophysiology, and introduces the critical structures which, when damaged, predispose an otherwise healthy atrium to AF. The available evidence that ROS can lead to damage of these critical structures is then reviewed. Finally, the evidence linking the process of aging to the pathogenesis of AF is discussed.

Mitochondrial DNA 4977bp Deletion Mutation in Peripheral Blood Reflects Atrial Remodeling in Patients with Non-Valvular Atrial Fibrillation

“…However, whether ROS and mitochondrial dysfunction as result of the ageing process alone are sufficient to produce an arrhythmogenic atrial substrate remain in question. 15 In our study, we observed that among AF patients, those with the mtDNA mutation were older on average. In comparison to their age-matched controls, elderly AF patients still maintained a higher prevalence of mtDNA 4977 - mut .…”

“…According to recent studies, the mechanism underlying aging is primarily a progressive decline in mitochondrial function. 15 Leakage of superoxide from the mitochondrial electron transport chain induces oxidative damage and accumulation of damage over time results in mtDNA deletion. 16 , 17 mtDNA 4977 - mut is one of the most common deletion mutations identified in mitochondria.…”

Circulating ceruloplasmin, ceruloplasmin-associated genes, and the incidence of atrial fibrillation in the atherosclerosis risk in communities study

“…This oxidative stress may produce cardiac electrical activity alterations, damaging ion channels and finally leading to the AF development. (22,23)…”

Association between red blood cell parameters & atrial fibrillation after acute myocardial infarction

“…In our clinical experience, a good parameter for the occurrence of AF is ageing, which is referred to as an oxidative condition 3 . We have paid special attention to the relevance of oxidative stress in cardiometabolic pathologies.…”

“…We have paid special attention to the relevance of oxidative stress in cardiometabolic pathologies. Notably, oxidative stress conditions are involved in the pathogenesis of AF 3 4 . Thus, we wonder if some patients had a relatively high red blood cell level (even though it was not at the level of polycytemia), which could have led to oxidative stress.…”