Conclusions Our meta- analysis indicates that vitamin C may prevent post-operative atrial fibrillation in some countries outside of the USA , and it may also shorten the duration of hospital stay and ICU stay of cardiac surgery patients .
Vitamin C is an essential nutrient that is safe and inexpensive .
Background Atrial fibrillation ( AF ) , a common arrhythmia contributing substantially to cardiac morbidity , is associated with oxidative stress and , being an antioxidant , vitamin C might influence it .
Ascorbate Attenuates Atrial Pacing-Induced Peroxynitrite Formation and Electrical Remodeling and Decreases the Incidence of Postoperative Atrial Fibrillation
Atrial fibrillation ( AF ) , the most common chronic arrhythmia , increases the risk of stroke and is an independent predictor of mortality . Available pharmacological treatments have limited efficacy . Once initiated , AF tends to self-perpetuate , owing in part to electrophysiological remodeling in the atria ; however , the fundamental mechanisms underlying this process are still unclear . We have recently demonstrated that chronic human AF is associated with increased atrial oxidative stress and peroxynitrite formation ; we have now tested the hypothesis that these events participate in both pacing-induced atrial electrophysiological remodeling and in the occurrence of AF following  cardiac surgery . In chronically instrumented dogs , we found that rapid ( 400 min−1 ) atrial pacing was associated with attenuation of the atrial effective refractory period ( ERP ) . Treatment with ascorbate , an antioxidant and peroxynitrite decomposition catalyst , did not directly modify the ERP , but attenuated the pacing-induced atrial ERP shortening following 24 to 48 hours of pacing . Biochemical studies revealed that pacing was associated with decreased tissue ascorbate levels and increased protein nitration ( a biomarker of peroxynitrite formation ) . Oral ascorbate supplementation attenuated both of these changes . To evaluate the clinical significance of these observations , supplemental ascorbate was given to 43 patients before , and for 5 days following , cardiac bypass graft surgery . Patients receiving ascorbate had a 16.3 % incidence of postoperative AF , compared with 34.9 % in control subjects . In combination , these studies suggest that oxidative stress underlies early atrial electrophysiological remodeling and offer novel insight into the etiology and potential treatment of an enigmatic and difficult to control arrhythmia . The full text of this article is available at http://www.circresaha.org
Conclusions Our meta- analysis indicates that vitamin C may prevent post-operative atrial fibrillation in some countries outside of the USA , and it may also shorten the duration of hospital stay and ICU stay of cardiac surgery patients .
Vitamin C is an essential nutrient that is safe and inexpensive .
Background Atrial fibrillation ( AF ) , a common arrhythmia contributing substantially to cardiac morbidity , is associated with oxidative stress and , being an antioxidant , vitamin C might influence it .