The Vital Significance of Cellular Energy in Cardiac Arrhythmias

• Atrial fibrillation (AF) is a worldwide health issue affecting millions and increases significantly with age. It significantly impacts quality of life and places a considerable economic strain on healthcare systems
• Mitochondrial dysfunction plays a critical role in the development of AF, affecting energy production, cellular ion balance, and oxidative stress levels. This dysfunction contributes to both electrical and structural remodeling of the heart
• Certain existing medications, especially those used for diabetes management such as DPP-4 inhibitors and SGLT2 inhibitors, show potential in improving mitochondrial function and possibly reducing AF risk
• Emerging therapies focusing on mitochondrial function, including new drugs and gene therapies, are being developed and may offer new strategies for AF prevention and treatment in the future
• Promoting mitochondrial health through lifestyle choices and discussing mitochondrial-targeted therapies with healthcare providers may help reduce AF risk, particularly as you age.

Atrial fibrillation (AF) is a silent epidemic that is gradually affecting people worldwide. As the most prevalent type of irregular heart rhythm, it impacts millions globally, with prevalence estimates between 1% and 2% in the U.S. general population.

In AF, your heart’s electrical system malfunctions, leading to irregular and sometimes rapid rhythms. This significantly increases your stroke risk—up to five times higher. The reason is that your irregular heartbeat can cause blood to pool and clot in your heart, which can then travel to your brain.

What’s particularly concerning is the dramatic increase in AF risk with age. While it’s relatively rare in younger adults, affecting only about 0.1% of those under 55, the prevalence is estimated at 6.4% for those aged 65 to 69, and 28.5% for those over 85.

However, AF isn’t just an issue for the elderly. In some cases, it can strike at a much younger age due to genetic factors or congenital heart defects. For these younger patients, the cause is often found in the pulmonary veins, where abnormal electrical activity can trigger AF episodes. While this type of AF, known as paroxysmal AF, can often be successfully treated with pulmonary vein ablation, the situation is different for older patients.

As you age, your heart tissue naturally degenerates, and various health conditions can affect your heart’s structure and metabolism. These factors create an environment conducive to persistent or permanent AF, which is much harder to treat effectively.