title: Effects of chronic omega-3 polyunsaturated fatty acid supplementation on human atrial mechanical function after reversion of atrial arrhythmias to sinus rhythm: reversal of tachycardia-mediated atrial cardiomyopathy with fish oils.
abstract: BACKGROUND
  Atrial mechanical stunning is a form of tachycardia-mediated atrial cardiomyopathy that manifests after reversion of persistent atrial arrhythmias to sinus rhythm.
  
  
  OBJECTIVE
  This study sought to examine whether chronic omega-3 polyunsaturated fatty acid supplementation with fish oils can reverse atrial mechanical stunning.
  
  
  METHODS
  Patients undergoing reversion of persistent atrial fibrillation (AF) or atrial flutter (AFL) to sinus rhythm were randomized to a control group (n = 26) or an omega-3 group (n = 23). The latter were prescribed 6 g/day of fish oil for ≥1 month prior to the procedure. Parameters of left atrial appendage function were compared immediately before and immediately after reversion.
  
  
  RESULTS
  After fish oil intake for a mean of 70 days, the following were noted favoring the omega-3 group among both AF and AFL patients: (1) 2-fold higher serum omega-3 levels (P < .001), (2) less mean decrease in emptying velocity (e.g., AF: 8% vs. 32%, P = .02), (3) less mean decrease in appendage emptying fraction (e.g., AFL: 7% vs. 60%, P = .002), (4) lower incidence of new or increased spontaneous echocardiographic contrast (e.g., AF: 11% vs. 62.5%, P = .003), and (5) lower incidence of atrial mechanical stunning (e.g., AFL: 20% vs. 100%, P = .001). Omega-3 intake conferred protection against stunning in a multivariable analysis (odds ratio 0.18, P = .02).
  
  
  CONCLUSIONS
  Chronic fish oil ingestion in humans attenuates atrial mechanical stunning after reversion of atrial arrhythmias to sinus rhythm. This suggests that fish oils may target or even reverse underlying cellular and/or structural remodeling that occurs in response to persistent atrial arrhythmias.
authors.affiliation: Cardiology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.forename: Fiona
authors.initials: F
authors.lastname: Sutherland
authors.forename: Miriam
authors.initials: M
authors.lastname: Wheeler
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Heck
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Lee
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Teh
authors.forename: Manohar L
authors.initials: ML
authors.lastname: Garg
authors.forename: John G
authors.initials: JG
authors.lastname: Morgan
authors.forename: Paul B
authors.initials: PB
authors.lastname: Sparks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy; D001282:Atrial Flutter / Q000628:therapy; D009202:Cardiomyopathies / Q000209:etiology; D019587:Dietary Supplements; D004554:Electric Countershock; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005260:Female; D006325:Heart Atria / Q000187:drug effects* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3