Research progress on applying plant-derived natural calcium channel blockers in the antiarrhythmic drug development

Arrhythmia is the abnormal heart-beat frequency and/or rhythm caused by the origin of cardiac activity and/or conduction disorder. Arrhythmia disease has various manifestations and complex etiology, which can occur alone or complicated with other cardiovascular diseases. A sudden arrhythmic onset may lead to sudden death, whereas a sustained onset may lead to heart failure. In cardiomyocytes, calcium overload induces apoptosis and leads to arrhythmia. Calcium channel blockers have been widely used in clinic as a routine cardiovascular drug to regulate calcium signal, but their efficacy on different arrhythmia complications vary, and they also have potential therapeutic risks. Therefore, it is of great significance to seek calcium signal modulators targeting new mechanisms from plants and other natural product resources and develop them into anti-arrhythmia drugs with higher safety and better curative effect. This review focuses on the calcium signal regulatory effects of plant-derived natural calcium channel antagonists in arrhythmia models, highlights the research progress in recent years, and summarizes the effects and mechanisms of various natural drugs such as alkaloids, saponins, quinones and flavonoids, which regulate Ca²⁺ homeostasis, to provide a theoretical basis for the drug development of natural calcium channel antagonists to prevent and treat arrhythmia in the future.