Atrial fibrillation is the most common sustained cardiac arrhythmia. Obesity and metabolic syndrome are independent risk factors for atrial fibrillation, and epicardial adipose tissues are highly associated with the genesis of atrial fibrillation, compared to visceral fat. Adipocytes can produce inflammatory cytokines and adipocytokines, which may enhance inflammation and oxidative stress in patients with obesity or metabolic syndrome. Moreover, it is possible that local interactions between epicardial adipose tissue and the adjacent myocardium can directly produce electrical or structural remodelings in the atrium. Taken together, we hypothesized that epicardial adipocytes contain distinctive arrhythmogenicity through increases in inflammatory cytokines, adipocytokines, and adipocyte-cardiomyocyte interactions to induce atrial fibrillation.
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