Figure 1.

Adipocytes have numerous physiologic effects on myocytes including but not limited to endocrine, inflammatory, autonomic regulation, oxidative, autophagy, and electrical. When homeostasis is dysregulated due to excess adipocyte burden, no matter where the location, there is opportunity for arrhythmia. Excessive adipose tissue can be a source of increased ROS, aberrant autophagy, intracellular calcium dysregulation, autonomic tone augmentation, a cause of block and reentry among others.