Antioxidant Therapy for Atrial Fibrillation: Lost in Translation?

Despite considerable evidence suggesting a central role for oxidative stress in pathogenesis of atrial fibrillation (AF), use of conventional reactive oxygen species (ROS) scavengers have not shown impressive results. ROS are a wide range of highly active molecules that can react quickly with their local surroundings. This characteristic may be part of the reason that general antioxidants have not been clinically effective. A probably more efficacious approach would be to inhibit the correctly identified major sources of ROS. Mitochondria and NADPH oxidase may be the most important sources of ROS in AF, and their inhibition may prove effective antiarrhythmic therapies.