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. 2021 Sep 14;42(35):3521-3525.
doi: 10.1093/eurheartj/ehab467.

Does gut microbiota affect atrial rhythm? Causalities and speculations

Dominik Linz  1   2   3   4 , Monika Gawałko  1   2   5   6 , Prashanthan Sanders  3 , John Penders  7 , Na Li  8 , Stanley Nattel  6   9   10 , Dobromir Dobrev  6   9   11
Affiliations

Does gut microbiota affect atrial rhythm? Causalities and speculations

Dominik Linz et al. Eur Heart J. .

Abstract

Dietary intake has been shown to change the composition of gut microbiota and some changes in microbiota (dysbiosis) have been linked to diabetes, hypertension, and obesity, which are established risk factors for atrial fibrillation (AF). In addition, intestinal dysbiosis generates microbiota-derived bioactive metabolites that might exert proarrhythmic actions. Although emerging preclinical investigations and clinical observational cohort studies suggest a possible role of gut dysbiosis in AF promotion, the exact mechanisms through which dysbiosis contributes to AF remain unclear. This Viewpoint article briefly reviews evidence suggesting that abnormalities in the intestinal microbiota play an important and little-recognized role in the pathophysiology of AF and that an improved understanding of this role may open up new possibilities in the management of AF.

Keywords: Arrhythmia; Atrial fibrillation; cardiometabolic; dysbiosis; gut microbiota; metabolites.

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Figures

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Putative mechanisms of gut microbiota-associated atrial fibrillation. Lifestyle components and diet directly impact the gut microbiota composition (homeostasis left, dysbiosis right) and the gut microbiota-derived metabolites. Gut microbiota-derived metabolites (beneficial metabolites in green, detrimental metabolites in red) contribute to the development of atrial arrhythmogenic remodelling and atrial fibrillation-promoting comorbidities, leading to both ectopic firing and a re-entrant substrate for atrial fibrillation maintenance. BA, bile acids; LPS, lipopolysaccharide; SCFA, short-chain fatty acids; TMA, trimethylamine; TMAO, trimethylamine N-oxide; Trp, tryptophan.
See this image and copyright information in PMC

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