Epicardial adipose tissue (EAT) or epicardial fat tissue (EFT) affect cardiac electrical impulse through chemical secretion. Change of electrical cardiac impulse may lead into cardiac arrhythmia. Measurement of EAT correlates to the prognosis of cardiac arrhythmia cases caused by inflammatory and fibrotic properties which facilitate arrhythmogenesis. The aim of this study is to review the change of cardiac impulses and arrythmias correlation to EAT. Epicardial Adipose Tissue, Epicardial Fat, Electrocardiography, and Arrhythmia were used as keywords. Studies that we include were published between 2015 and 2021. We use inclusion and exclusion criteria to select included studies. We included five observational studies. This review includes 644 patients with predominant male younger than 65 years old. Epicardial fat tissue thickness more than 5,35 mm and 9 mm correlates to increased P-wave dispersion and increased T peak-end (Tp-e)/QT ratio, and Tp-e/QTc duration. Thicker EAT also correlates to the presence of fragmented QRS (fQRS). We found no cut-off point to determine- increased EAT. Epicardial fat tissue thickness correlates to P-wave dispersion, Tp-e/QT, Tp-e/QTc ratio, and fQRS. Evaluation of these parameters in echocardiography examination might have beneficial value to predict arrythmia in patients, especially those with overweight or obesity.