Epigenetic implication in atrial fibrillation: a potential biomarker?

Atrial fibrillation (AF) remains the center of attention in cardiology and vascular medicine, besides coronary artery disease (CAD) and heart failure (HF). Not only how to manage the disease, but how to prevent it also attract the interest of the researcher. A biomarker is still a hot topic in AF. Although the current recommendation did not place biomarkers in a central role, the search for perfect biomarkers for AF is still ongoing. The epigenetic mechanism seems to have a pivotal role in explaining the gap in AF mechanism understanding. How previous cardiac condition, behavioral factor, and environmental factor interact with each other and result in the genesis of AF can be explained by an epigenetic mechanism. Epigenetic process altered the gene expression and, in the future, will result in the development of the disease. Three epigenetic mechanisms that had been identified are DNA methylation, histone modification, and microRNA (miRNA). Identification of these early changes is the subject of epigenetic biomarkers. This review will discuss the basic understanding of the epigenetic mechanism in AF and its potential role to be the new biomarkers.