Role of gut microbiota in post-operative atrial fibrillation: a randomized trial of berberine

Post-operative atrial fibrillation (POAF) is one of the most common complications. However, the underlying factors governing POAF are not well understood. The aim of this study was to investigate the relationship between gut microbiota and POAF. Then, we conducted a randomized, double-blind, placebo-controlled trial with patients underwent isolated coronary artery bypass grafting (CABG) in China to measure gut microbiota altering and impact on the incidence of POAF by oral berberine. Compared with no-POAF patients, gut microbiota composition was significantly altered, including Veillonella increasing. The POAF incidence was reduced from 35–20% under the treatment of berberine. Oral berberine significantly decreased Veillonella abundances, and lipopolysaccharide (LPS), C-reactive protein (CRP) and Interleukin- 6 (IL-6) level. Elevated LPS after surgery is associated with POAF. Our results showed that POAF patients show significantly gut microbiota shift. Altering gut microbiota like oral berberine reduced the POAF.