Work

Arrhythmic Burden After Myocarditis: From Molecular Mechanisms to Therapeutic Strategies

Year: 2026

Type: article

Abstract: Myocarditis is an underdiagnosed inflammatory condition ofthe myocardium that may lead to significant complications, including life-threatening ventricular arrhythmias and sudden cardiac death, particularly in young individuals. The arrhythmogenic substrate evolves dynamically across the disease course, driven by acute inflammation, ion channel alterations, immune-mediated cytotoxicity and negative structural remodelling. Persistent myocardial inflammation and fibrosis promote conduction abnormalities, triggered activity and re-entrant circuits, creating a pro-arrhythmic milieu. Despite increasing recognition of its clinical relevance, arrhythmias management in myocarditis remains challenging due to the variability in patient presentation and disease trajectory. This review examines arrhythmogenic mechanisms associated with myocarditis, exploring differential contribution of the above-reported triggers to concurrent electrical instability. Updated therapeutic approaches to managing arrhythmias in myocarditis are discussed, with emphasis on the importance of individualised treatment plans. A deeper understanding of the complex interplay between inflammation and arrhythmias may improve clinical decision-making, and help tailor individualised management strategies for affected patients.

Source: European Cardiology Review

DOI: 10.15420/ecr.2025.52

Authors: Antonio Curcio, Letizia Rosa Romano, Claudia Rocca, Giovanni Lopes, Rossella Quarta

Institution: University of Calabria

Language: English

Topic: Viral Infections and Immunology Research

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,146