ABSTRACT
<p><b>OBJECTIVE</b>The purpose of this review was to delineate our current knowledge of the close relationship between the abundance of epicardial adipose tissue (EAT) and the risk of all major cardiovascular disease, especially atrial fibrillation (AF).</p><p><b>DATA SOURCES</b>The data analyzed in this review were mainly from articles reported in PubMed published from 1972 to 2014.</p><p><b>STUDY SELECTION</b>Original articles and critical reviews relevant to EAT and AF were selected.</p><p><b>RESULTS</b>EAT, a particular form of metabolically active visceral fat deposited around the heart, is being regarded as an important independent predictor of cardio-metabolic diseases. EAT is composed of smaller adipocytes than other visceral fat depots and functioned like brown adipose tissue (BAT) to protect adjacent tissues. Improving the understanding of EAT in AF genesis and maintenance may contribute to prevent AF and reduce the complications associated with AF.</p><p><b>CONCLUSION</b>The findings suggest that EAT associates with AF severity and the recurrence of AF after catheter ablation even after adjustment for AF risk factors, but the precise mechanisms are not fully elucidated.</p>