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Erschienen in: Herz 2/2019

07.02.2019 | Main topic

Critical inflammatory mechanisms underlying arrhythmias

verfasst von: N. Vonderlin, J. Siebermair, E. Kaya, M. Köhler, T. Rassaf, Univ.-Prof. Dr. med. R. Wakili

Erschienen in: Herz | Ausgabe 2/2019

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Abstract

During the past few decades, cardiovascular research has increasingly focused on systemic inflammatory mechanisms, particularly in the field of atherosclerosis but also in association with cardiac arrhythmogenesis. Objective inflammatory markers including C‑reactive protein and cytokines, also called “biomarkers,” seem to serve as predictors of onset and prognosis of cardiac arrhythmias. This review gives an overview of potential mechanisms underlying inflammatory processes and arrhythmias, especially atrial fibrillation, which is the most common sustained arrhythmia in daily clinical routine. The association between inflammatory pathways and cardiac arrhythmia is highly complex and includes direct as well as indirect pathways. While past research into arrhythmia focused on fibrosis, altered action potential properties, and ischemia, novel concepts include coagulation and inflammation in cardiac tissue. The underlying mechanisms are altered electrophysiological properties, including ion channel disturbance, early and late afterdepolarizations, as well as enhanced fibrosis and structural remodeling in cardiomyopathies. These pathophysiological factors favor the occurrence of ectopic pacemakers as well as re-entry tachycardia. Further studies are essential to better understand the main inflammatory signal cascades and the exact proarrhythmic effect of interacting key mediators. This will facilitate the evaluation of future anti-inflammatory therapeutic approaches for arrhythmias, analogous to recent developments in atherosclerosis.
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Metadaten
Titel
Critical inflammatory mechanisms underlying arrhythmias
verfasst von
N. Vonderlin
J. Siebermair
E. Kaya
M. Köhler
T. Rassaf
Univ.-Prof. Dr. med. R. Wakili
Publikationsdatum
07.02.2019
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 2/2019
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-019-4788-5

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