Interleukin-8 and atrial fibrillation

A large number of studies have now documented that atrial fibrillation (AF) is often associated with inflammation.1 Given that AF predisposes to stroke and thrombo-embolism and is associated with a hypercoagulable or prothrombotic state, the causal relationship among these ‘partners-in-crime’—that is, inflammation and thrombosis—is still a matter of intense debate. Besides its intellectual thrill, this quest may have very practical implication in pinpointing specific targets for the prevention of AF or stroke. The relationship between AF and inflammation is evident when studied locally in atrial tissue or at the level of ‘whole’ organism, using biomarkers in the systemic circulation. Examination of atrial biopsies from subjects with paroxysmal AF but without other cardiovascular disease documented myocarditis confined to atria in almost 2/3 of cases.1 Another example is AF in post-thoracotomy patients where inflammatory pericarditis is a significant contributor. Indeed, sterile pericarditis induced by talcum dust in dogs is associated with increased ability to sustain AF.2 This suggests that focal atrial inflammation per se can be the primary cause of AF in a part of AF subjects. Besides this local milieu, AF patients often demonstrate signs of low-grade systemic inflammation as evidenced by the elevation of inflammatory biomarkers in the systemic circulation, such as C-reactive protein … *Corresponding author. Tel: +420 236 055 190; fax: +420 261 362 985. E-mail address : vojtech.melenovsky{at}ikem.cz or vome{at}medicon.cz