Epicardial Fat, Paracrine-mediated Inflammation and Atrial Fibrillation

Abstract

Atrial fibrillation is the most frequent arrhythmia in adults, becoming more frequent with age. Recent clinical studies demonstrated that epicardial fat is linked with atrial fibrillation induction and recurrence. The arrhythmogenic mechanism consists in the fact that the epicardial adipose tissue is metabolically active, inducing local inflammation and enhancing the oxidative stress, which lead to atrial fibrillation as well as atherosclerosis. Having metabolic activity and secreting various anti- and pro-inflammatory biomarkers, the fat surrounding the heart has been linked to the complex process of coronary plaque vulnerabilization. This clinical update aims to summarize the role of epicardial adipose tissue in the pathogenesis, persistence, and severity of atrial fibrillation.

Epicardial Fat-mediated Inflammation: a Major Player in Cardiovascular Diseases

“…14 Another article published in this issue by Rat et al presents a clinical update on the role of EAT in left atrial remodeling and genesis of AF, showing that EAT is associated not only with a higher risk for AF but also with a higher recurrence rate after successful catheter ablation of AF. 15 This interesting new hypothesis indicates a potential role of EAT in the development of atrial remodeling, similar to previous observations on the correlation between EAT and left ventricular remodeling following an acute myocardial infarction. 6 It is well-known that in the period following an acute myocardial infarction, an exacerbated inflammation is responsible for worse outcomes and ventricular remodeling.…”