Biomarkers in atrial fibrillation, ventricular arrhythmias, and sudden cardiac death

Cardiac arrhythmias including atrial fibrillation, ventricular tachycardia, and ventricular fibrillation are important causes of cardiovascular morbidity and mortality. Although they usually occur in the setting of structural heart disease, these arrhythmias can be the primary manifestation of subclinical cardiovascular disease and have deleterious consequences including stroke, heart failure, and death. Investigational efforts have focused on developing risk stratification algorithms and diagnostic methods to identify patients who are most likely to sustain cardiac arrhythmias and benefit from early pharmacologic and interventional therapies. This review highlights important clinical and translational studies that identify potential biological markers to predict the onset of cardiac arrhythmias and their complications. Particular focus is placed on mechanisms involving the neurohormonal system, inflammation, the renin-angiotensin-aldosterone system, and metabolic pathways.