Early reperfusion is crucial for the survival of ischemic myocardium. However, reperfusion has been referred by Braunwald and Kloner 1) as the "double edged sword" because reperfusion itself may lead to accelerated and additional myocardial injury beyond that generated by ischemia alone. This results in a spectrum of reperfusion-associated pathologies, collectively called "reperfusion injury."2) Reperfusion injury has been observed in each of reperfusion therapies including percutaneous coronary intervention (PCI), thrombolysis and coronary bypass grafting. The different clinical manifestations of this injury include myocardial necrosis, myocardial apoptosis, reperfusion arrhythmias, myocardial stunning and endothelial-and microvascular dysfunction including the no-reflow phenomenon.3) However, ventricular tachycardia (VT) and ventricular fibrillation (VF) induced by reperfusion remain the most important causes of sudden death following spontaneous restoration of antegrade flow. 4,5) Therefore, every effort must be made to minimize sudden cardiac death caused by reperfusion arrhythmias. The mechanisms of reperfusion arrhythmias may include heterogeneous recovery of conduction and a refractory period of incomplete reperfusion, reentry, abnormal automaticities, and activities triggered by Ca 2ϩ overload and free radicals. [6][7][8][9] However, the details of the mechanisms remain unclear and reperfusion arrhythmia has not received satisfactory treatment.Grape seed proanthocyanidin extract (GSPE) is a natural, standardized, water-ethanol extract from red grape seeds which has great free radical scavenging ability. The main pharmacological effective components of GSPE are oligomeric proanthocyanidins. Free radicals and oxidative stress play a crucial role in the pathophysiology of a broad spectrum of cardiovascular diseases including congestive heart failure, valvular heart disease, cardiomyopathy, hypertrophy, atherosclerosis and ischemic heart disease. A series of studies were conducted using GSPE to demonstrate its cardioprotective ability in animals and humans. [10][11][12][13][14] Our previous work had shown GSPE reduced reperfusioninduced arrhythmias in rabbits. 15) In isolated rat hearts GSPE had been proved to reduce the incidence of reperfusion-induced VF and VT.11) However the mechanism of this protection against reperfusion-induced VT, VF by GSPE remained unclear. Proteomic studies of heart tissues can provide new insights into the specific early molecular mechanisms that underlie the responses to ischemia reperfusion (IR) injury and therefore may have vital implications for the specificity and efficacy of diagnosis and treatment. Despite their biological significance, the investigation of membrane proteomics is technically limited by the relatively high molecular masses and hydrophobicities of these proteins.16) With the development of proteomic techniques a quantitative proteomics-isobaric tags for relative and absolute quantification (iTRAQ) was introduced to solve these problems. iTRAQ employs prima...