Long-term omega-3 polyunsaturated fatty acid supplementation reduces the recurrence of persistent atrial fibrillation after electrical cardioversion

Heart Rhythm, 04/19/2012

Omega–3 polyunsaturated fatty acid supplementation commenced >1 month prior to electrical cardioversion and continued thereafter reduces the recurrence of persistent atrial fibrillation (AF). Randomized controlled trials on long–term fish oil supplementation are needed to confirm these findings.

Methods

  • This was an open–label, randomized study of 178 patients with persistent AF >1–month duration.
  • Participants were assigned to control group (n = 87) or omega–3 group (6 g/d fish oil; n = 91) and underwent cardioversion 1 month later.
  • Concurrent antiarrhythmic use of sotalol or amiodarone was permitted.
  • Fish oil was continued till return of persistent AF or a maximum of 1 year.
  • Intention–to–treat analysis was performed for the primary end point defined as the recurrence of persistent AF.

Results

  • Mean duration of fish oil intake was 56 days precardioversion and a total of 242 days in follow–up.
  • Eicosapentaenoic acid and docosahexaenoic acid, the active components of fish oils, were 1.8–fold and 2.1–fold higher, respectively, in the omega–3 group compared with controls at the time of cardioversion (P <.001).
  • At 90 days, 38.5% of the patients receiving omega–3 fatty acid supplement had AF recurrence compared with 77.5% of the controls (hazard ratio [omega–3 vs control] 0.38; 95% confidence interval 0.27–0.56; P <.001).
  • Omega–3 intake was associated with a significant reduction in AF recurrence with or without concurrent antiarrhythmic drugs.

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