Fig. 1

The arrhythmogenic effects of obesity on cardiomyocytes. Obesity is closely related to systemic hemodynamic changes, hypertension, sleep apnea syndrome, diabetes, and increased local epicardial fat. These systemic and local changes promote inflammation and oxidative stress, as well as activating the ganglionic plexus, leading to structural remodeling including fibrosis, left atrial enlargement, and electrical remodeling including conduction slowing and heterogeneity enhancing, and ultimately cause atrial fibrillation. OSA Obstructive sleep apnea, ROS Reactive oxygen species, NO nitric oxide, d-ROM derivative of reactive oxidative metabolites