Abstract
Arrhythmia is an important cause of cardiovascular disease deaths and a serious threat to human health, but the current means of identification are limited. Biomarkers, with the advantages of easy access and rapid detection, have shown significant value in arrhythmia risk prediction, precision diagnosis, and prognosis assessment. In recent years, with the development of molecular biology and multiomics technology, some novel biomarkers have made great breakthroughs in revealing the pathological mechanisms of arrhythmia. However, clinical translation still faces challenges such as a lack of standardization of assays and insufficient clinical prospective validation. This review comprehensively searched studies published between 2010 and 2025 in PubMed, Web of Science, Embase, and CENTRAL databases, focusing on the mechanisms underlying the role of arrhythmia biomarkers in inflammation, fibrosis, autoimmunity, and electrical remodeling and clinical translation potential. Future research should focus on the combined application of multiple biomarkers and the discovery of subtype-specific markers. Conducting large-scale, multicenter studies to validate these biomarkers and ultimately integrate them into clinical practice is crucial for advancing biomarker-guided individualized antiarrhythmic therapy.