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Review
. 2022 Jun 2;11(6):1109.
doi: 10.3390/antiox11061109.

Antioxidants in Arrhythmia Treatment-Still a Controversy? A Review of Selected Clinical and Laboratory Research

Jakub Szyller  1 , Dariusz Jagielski  2 , Iwona Bil-Lula  1
Affiliations
Review

Antioxidants in Arrhythmia Treatment-Still a Controversy? A Review of Selected Clinical and Laboratory Research

Jakub Szyller et al. Antioxidants (Basel). .

Abstract

Antioxidants are substances that can prevent damage to cells caused by free radicals. Production of reactive oxygen species and the presence of oxidative stress play an important role in cardiac arrhythmias. Currently used antiarrhythmic drugs have many side effects. The research on animals and humans using antioxidants (such as vitamins C and E, resveratrol and synthetic substances) yields many interesting but inconclusive results. Natural antioxidants, such as vitamins C and E, can reduce the recurrence of atrial fibrillation (AF) after successful electrical cardioversion and protect against AF after cardiac surgery, but do not affect the incidence of atrial arrhythmias in critically ill patients with trauma. Vitamins C and E may also effectively treat ventricular tachycardia, ventricular fibrillation and long QT-related arrhythmias. Another natural antioxidant-resveratrol-may effectively treat AF and ventricular arrhythmias caused by ischaemia-reperfusion injury. It reduces the mortality associated with life-threatening ventricular arrhythmias and can be used to prevent myocardial remodelling. Statins also show antioxidant activity. Their action is related to the reduction of oxidative stress and anti-inflammatory effect. Therefore, statins can reduce the post-operative risk of AF and may be useful in lowering its recurrence rate after successful cardioversion. Promising results also apply to polyphenols, nitric oxide synthase inhibitors and MitoTEMPO. Although few clinical trials have been conducted, the use of antioxidants in treating arrhythmias is an interesting prospect.

Keywords: antioxidants; atrial fibrillation; resveratrol; ventricular arrhythmia; vitamin C; vitamin E.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main molecular mechanisms of ROS and selected antioxidants in cardiac arrhythmias.
Figure 2
Figure 2
The main effects of vitamins C and E on cardiac arrhythmias.
Figure 3
Figure 3
The main effects of resveratrol on cardiac arrhythmias. The effects may also depend on the simultaneous consumption of alcohol.
Figure 4
Figure 4
The main effects of statins on cardiac arrhythmias. Their antiarrhythmic activity is probably related to the influence on oxidative stress and the bioavailability of ROS, as well as modulation of the inflammatory response.
Figure 5
Figure 5
Natural and synthetic antioxidants in the proposed therapy for cardiac arrhythmias.
See this image and copyright information in PMC

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