Integrative approaches to atrial fibrillation prevention and management: Leveraging gut health for improved cardiovascular outcomes in the aging population

• Published in: Current problems in cardiology 2024-12, Vol.50 (3), p.102952, Article 102952
• Main Authors: Williams, Emma Grace, Alissa, Mohammed, Alsugoor, Mahdi H., Albakri, Ghadah Shukri, Altamimi, Ali A, Alabdullateef, Abdulmajeed Abdulaziz, Almansour, Nahlah Makki, Aldakheel, Fahad M., Alessa, Salem, Marber, Michael
• Format: Article
• Language: English
• Subjects: Atrial fibrillation; diabetes; Intestinal flora; Metabolite; Old age; Secondary bile acids; Trimethylamine N-oxide
• ISSN: 0146-2806; 1535-6280; 1535-6280
• DOI: 10.1016/j.cpcardiol.2024.102952

•First comprehensive review exploring the intricate relationship between gut microbiota and atrial fibrillation in elderly populations.•Reveals critical, previously overlooked mechanisms linking intestinal flora dysbiosis to cardiac arrhythmia pathogenesis.•Demonstrates the potential of microbiome-based interventions as innovative therapeutic strategies for atrial fibrillation management.•Identifies key metabolites (trimethylamine N-oxide, secondary bile acids) as potential biomarkers and therapeutic targets.•Proposes future research directions for personalized, microbiome-informed cardiovascular interventions. Atrial fibrillation (AF) is a prevalent clinical arrhythmia associated with a high incidence and severe complications such as cerebral embolism and heart failure. While the etiology and pathogenesis of AF involve numerous factors, recent research emphasizes the significant role of intestinal microbiota imbalance in the emergence and progression of AF, particularly among older adults. This review investigates the mechanisms by which intestinal flora and their metabolites contribute to the onset of AF in the elderly, highlighting novel interactions between gut health and cardiac function. Current literature often overlooks these critical connections, indicating a substantial research gap in understanding how dysbiosis may exacerbate AF and hinder recovery. Furthermore, exploring the bidirectional relationship between the gut microbiome and systemic inflammation in the context of AF provides a unique perspective that has yet to be thoroughly investigated. Future research should focus on longitudinal studies assessing gut microbiota composition and function in AF patients and consider probiotics or prebiotics as potential adjunctive therapies for mitigating AF. This comprehensive approach may pave the way for innovative treatments integrating cardiology with gastroenterology, enhancing patient outcomes through a holistic understanding of health.