A review of the literature data on the role of imbalance of cellular adhesion proteins (CAP) of the heart in the development of cardiac arrhythmias and heart failure. The CAPS of the intercalated discs belonging to the cadherin and desmin groups provide a mechanical connection of cardiomyocytes, proteins from the connexin group are responsible for the transmission of an electrical impulse. The imbalance of CAP has mainly a hereditary origin and is accompanied by the destruction of intercalated discs, block-age of impulse transmission with the development of electrical instability of the myocardium and cardiac arrhythmias, including ventricular and atrial fibrillation. This is the case with cardiomyopathies, coronary heart disease. Endothelial dysfunction also plays an essential role in atrial fibrillation, which is associated with an imbalance in the CAP of the endothelial lining of the endo-cardium and blood vessels. © 2024, Media Sphera Publishing Group. All rights reserved.