The pathogenic role of VLDL in MetS-related atrial cardiomyopathy, exhibited with structurally (in pink blocks) and electrical (in blue blocks) remodeling. The structural remodeling includes atrial dilatation, ventricular dilatation, and hypertrophy associated with impaired contractility, along with increased myocardial apoptosis, excessive lipid accumulation (consistent with EHRAS class IVf of atrial cardiomyopathy [10]), sarcomere disorders and myofilament derangements, and mitochondria morphological changes. The electrical remodeling includes shortening of action potentials [90], triggered activities, delayed intra-cardiac conduction, vulnerability to AF upon sympathetic stimulation, and unprovoked occurrence of AF. SOCE: store-operated calcium entry, NFAT: nuclear factor of activated T cells.