Ischemic Preconditioning in Atrial Fibrillation

DISCOVERIES (ISSN 2359-7232), 2025, volume 13

_{ORIGINAL ARTICLE}

_{FULL text (PDF)}

_{CITATION: Mohamed MA, Gorva S, Hamoud A, Benedict F, Rodrigues BS, Gonzales P, Dora S, Kwon M, Fernandes C, Mette NN. Ischemic Preconditioning in Atrial Fibrillation. Discoveries 2025, 13(3): e213. DOI: 10.15190/d.2025.12}

_{Ischemic Preconditioning in Atrial Fibrillation}

Mohamed Ahmed Mohamed ¹, Sankirtana Gorva ², Ahmad Hammoud ^3, *, Shiona Maria Benedict Fernandes ⁴, Brandon Sánchez ⁵, Pamela González ⁵, Srinjoy Dora ⁶, Minyoung Kwon ⁷, Calista Fernandes ⁸, Naga Nandini Mette ⁹

• ¹ David Tvildiani Medical University, Tbilisi, Georgia.
• ² Belagavi institute of medical sciences, Belgaum, Karnataka, India.
• ³ Ilia State University, Tbilisi, Georgia.
• ⁴ Ivane Javaskhilli Tbilisi State University, Tbilisi, Georgia.
• ⁵ Pontificia Universidad Católica Madre y Maestra, Santiago Province, Dominican Republic.
• ⁶ Tbilisi State Medical University, Tbilisi, Georgia.
• ⁷ University of Pennsylvania School of Dental Medicine, Philadelphia, USA.
• ⁸ Georgian National University SEU, Tbilisi, Georgia.
• ⁹ Siddhartha Medical College, Vijayawada, India.

 * Corresponding author: Ahmad Hammoud, Ilia State University, Tbilisi, Georgia; E-mail ID: ahmadhammoud266@gmail.com; tel: +995599890174

_Abstract

Atrial fibrillation (AF) is the most common arrhythmia worldwide with treatments such as anticoagulants, rate control, and catheter ablation only aiming to reduce complications. Ischemic preconditioning (IPC), defined as brief cycles of ischemia followed by reperfusion, has emerged as a promising cardioprotective strategy. This review aims to provide a comprehensive review on and discuss recent trials surrounding the use of ischemic preconditioning as a promising therapeutic alternative in the treatment of atrial fibrillation. Clinical trials in both surgical and interventional settings have shown encouraging evidence that these protective mechanisms can lead to meaningful reductions in atrial arrhythmia. Despite these encouraging findings, heterogeneity persists likely due to differences in patient selection, anesthetic regimens, and the timing or protocols of preconditioning. The collective evidence highlights the therapeutic potential surrounding the use of ischemic preconditioning in atrial fibrillation. With recent trials on the rise, IPC’s potential impact on rhythm control, pharmacologic responsiveness, cardioversion outcomes, and complication rates is highly promising for the treatment of atrial fibrillation. Further research is required to translate these findings into routine clinical practice, particularly in high-risk populations such as those with concurrent heart failure or structural heart disease.

_{Access FULL text of the manuscript here: FULL ARTICLE (PDF)}