Epicardial fat and ventricular arrhythmias

• Published in: Heart rhythm Vol. 21; no. 2; pp. 206 - 212
• Main Authors: Załęska-Kocięcka, Marta, Wojdyńska, Zuzanna, Kalisz, Małgorzata, Litwiniuk, Anna, Mączewski, Michał, Leszek, Przemysław, Paterek, Aleksandra
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2024
• Subjects: Anti-Arrhythmia Agents - therapeutic use; Arrhythmias, Cardiac; Death, Sudden, Cardiac - etiology; Epicardial Adipose Tissue; Epicardial fat; Humans; Premature ventricular complex; Ventricular arrhythmias; Ventricular tachycardia; Ventricular arrhythmias; Premature ventricular complex; Ventricular tachycardia; Epicardial fat; Epicardial adipose tissue
• ISSN: 1547-5271; 1556-3871; 1556-3871
• DOI: 10.1016/j.hrthm.2023.11.008

The arrhythmogenic role of epicardial adipose tissue (EAT) in atrial arrhythmias is well established, but its effect on ventricular arrhythmias has been significantly less investigated. Since ventricular arrhythmias are thought to cause 75%–80% of cases of sudden cardiac death, this is not a trivial issue. We provide an overview of clinical data as well as experimental and molecular data linking EAT to ventricular arrhythmias, attempting to dissect possible mechanisms and indicate future directions of research and possible clinical implications. However, despite a wealth of data indicating the role of epicardial and intramyocardial fat in the induction and propagation of ventricular arrhythmias, unfortunately there is currently no direct evidence that indeed EAT triggers arrhythmia or can be a target for antiarrhythmic strategies.