Association of Gut Dysbiosis with Potential Mechanisms Leading to Atrial Fibrillation: A Narrative Review

Abstract

Atrial fibrillation stands as one of the deadliest forms of arrhythmia known to mankind due to its severe complication and co-morbidities. Its association with gut dysbiosis is profound. The gut microbiota hosts a diverse variety of microbes crucial for immune function and protection against cardiovascular and metabolic diseases. Poor lifestyle habits such as diet, decreased physical activity, and drug disrupt this gut homeostasis. Multiple studies have provided compelling evidence linking alterations in gut microbiota to the risk and progression of atrial fibrillation. Some proposed mechanisms involve key metabolites such as trimethylamine N-oxide (TMAO), lipopolysaccharides, short-chain fatty acids (SCFAs), bile acids, and tryptophan. These mechanisms encompass inflammation, oxidative stress, autonomic dysfunction, atrial remodeling, altered electrical activity, and calcium homeostasis. This review meticulously examines gut dysbiosis and its pivotal role in the progression of atrial fibrillation through diverse potential mechanisms, emphasizing the significance of dietary factors and potential interventions.