title: Long-term omega-3 polyunsaturated fatty acid supplementation reduces the recurrence of persistent atrial fibrillation after electrical cardioversion.
abstract: BACKGROUND
  Persistent atrial fibrillation (AF) is associated with a high risk of recurrence after electrical cardioversion.
  
  
  OBJECTIVE
  We examined if long-term supplementation with omega-3 polyunsaturated fatty acids in fish oils commenced >1 month prior to electrical cardioversion and continued thereafter reduces recurrence of persistent AF.
  
  
  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.
  
  
  CONCLUSIONS
  Omega-3 polyunsaturated fatty acid supplementation commenced >1 month prior to electrical cardioversion and continued thereafter reduces the recurrence of persistent AF. Randomized controlled trials on long-term fish oil supplementation are needed to confirm these findings.
authors: Department of Cardiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors: Saurabh
authors: S
authors: Kumar
authors: Fiona
authors: F
authors: Sutherland
authors: Joseph B
authors: JB
authors: Morton
authors: Geoffrey
authors: G
authors: Lee
authors: John
authors: J
authors: Morgan
authors: James
authors: J
authors: Wong
authors: David E
authors: DE
authors: Eccleston
authors: John
authors: J
authors: Voukelatos
authors: Manohar L
authors: ML
authors: Garg
authors: Paul B
authors: PB
authors: Sparks
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D019587:Dietary Supplements; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013015:Sotalol / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D015525:Fatty Acids, Omega-3; D013015:Sotalol; D000638:Amiodarone