The role of epicardial adipose tissue and autonomic nervous system in pathophysiology of cardiac arrhythmias

The role of epicardial adipose tissue (EAT) in the pathogenesis and prognosis of cardiovascular diseases has been actively discussed. This review provides information regarding the main mechanisms by which EAT influences the pathophysiology of rhythm disturbances, such as atrial fibrillation and ventricular arrhythmias, as well as their relationship with chronic heart failure. The pathogenesis of cardiac arrhythmias is exceedingly complex. As such, the mechanism by which EAT influences arrhythmias and heart failure can vary according to the anatomy and type of arrhythmia, one of which involves the autonomic nervous system (ANS). Some studies have shown a good treatment effects by targeting EAT in atrial fibrillation, whereas others have found that EAT volume can be used to predict the efficacy of radiofrequency ablation, a method for treating atrial fibrillation and ventricular arrhythmias. However, no standards have yet been established for the use of EAT visualisation. Fundamental, translational and clinical research are needed to study the role of EAT and ANS in the pathogenesis of cardiovascular diseases.