Pharmacological interventions targeting atrial remodeling via anti-fibrotic, calcium-modulating, and anti-inflammatory mechanisms may mitigate atrial fibrillation after myocardial infarction.
This review highlights the pathophysiological mechanisms of post-MI atrial fibrillation and potential targeted pharmacological interventions to address atrial structural and electrical remodeling.
Abstract: Atrial Fibrillation (AF) following Myocardial Infarction (MI) is a common clinical complication that significantly impairs patient prognosis and quality of life. This review examines the clinical risks and underlying pathophysiological mechanisms of post-MI AF. The pathophysiology of AF after MI involves multiple maladaptive processes, particularly atrial structural and electrical remodeling, which collectively establish the arrhythmogenic substrate. This review summarizes the molecular mechanisms contributing to AF in the post-infarction setting. Furthermore, it was synthesized current evidence on pharmacological interventions targeting this substrate, highlighting four primary mechanisms of action: anti-fibrotic effects, modulation of calcium homeostasis, endogenous hormone regulation, and anti-inflammatory actions. Consequently, elucidating the complex and dynamic pathophysiological changes that drive atrial fibrillation after myocardial infarction may inform the development of targeted therapeutic strategies for post-infarction AF.
Wei et al. (2026) conducted a review in Atrial Fibrillation after Myocardial Infarction. Pharmacological interventions targeting atrial remodeling via anti-fibrotic, calcium-modulating, and anti-inflammatory mechanisms may mitigate atrial fibrillation after myocardial infarction.