Statins in paroxysmal atrial fibrillation: Beneficial to prevent recurrence but insufficient to stop progression

Atrial fibrillation (AF) is an increasingly prevalent cardiac arrhythmia, currently reaching pandemic proportions with over 33.5 million patients worldwide (1). AF presence independently increases morbidity and mortality, primarily because of thromboembolic stroke, heart failure, and vascular complications (2, 3). AF is characterized by complex electrical and structural remodeling of the atria that is often unrelated to the severity of the underlying cardiac disease (4). Current AF treatment focuses on controlling arrhythmia-related symptoms by antiarrhythmic medications and/or catheter ablation (5). Unfortunately, neither pharmacological nor ablative approach can completely cure AF; both treatment strategies are associated with a risk of complications, and the majority of patients still need life-long anticoagulation (5). Considering that AF pathogenesis is still incompletely understood, it is not surprising that the available treatments are suboptimal; hence, the development of antiarrhythmic therapies, which aim at mechanisms underlying AF occurrence and progression, seem particularly clinically relevant.