Peroxynitrite: in vivo cardioprotectant or arrhythmogen?

The factors that determine susceptibility to lethal ventricular arrhythmias during myocardial ischaemia and reperfusion in vivo are complex, but the balance between proarrhythmic and antiarrhythmic endogenous substances is likely to be important. However, in this context, it is not well established what effect endogenously produced peroxynitrite has on arrhythmias that develop during ischaemia/reperfusion in vivo. The study by Kiss et al., published in this issue of the BJP, provides some insights to this problem. We discuss the wider implications of this study as well as issues that still require resolution.