Consistent with those study, our research shows that H2S can improve the Warburg effect and mitochondrial function by inhibiting PDK-4 expression, reducing mitochondrial ROS and oxidative stress, and it’s also by inhibiting p-PERK-p-eIF2-α-ATF4 -CHOP-Caspase12 axis to reduce the occurrence of ERS and atrial muscle cell apoptosis, thereby improving the progression of atrial fibrosis to AF. Here, PDK4 is linked to atrial fibrillation.