title: A Randomized, Placebo-Controlled Trial of Omega-3 Fatty Acids for Inhibition of Supraventricular Arrhythmias After Cardiac Surgery: The FISH Trial.
abstract: BACKGROUND
  Omega-3 polyunsaturated fatty acids (n3-PUFAs) might have antiarrhythmic properties, but data conflict on whether n3-PUFAs reduce rates of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG). We hypothesized that n3-PUFAs would reduce post-CABG AF, and we tested this hypothesis in a well-powered, randomized, double-blind, placebo-controlled, multicenter clinical trial.
  
  
  RESULTS
  Patients undergoing CABG were randomized to pharmaceutical-grade n3-PUFAs 2 g orally twice daily (minimum of 6 g) or a matched placebo ≥24 hours before surgery. Gas chromatography was used to assess plasma fatty acid composition of samples collected on the day of screening, day of surgery, and postoperative day 4. Treatment continued either until the primary end point, clinically significant AF requiring treatment, occurred or for a maximum of 2 weeks after surgery. Two hundred sixty patients were enrolled and randomized. Before surgery, n3-PUFA dosing increased plasma n3-PUFA levels from 2.9% to 4% and reduced the n6:n3-PUFA ratio from 9.1 to 6.4 (both P<0.001). Similar changes were noted on postoperative day 4. There were no lipid changes in the placebo group. The rate of post-CABG AF was similar in both groups (30% n3-PUFAs versus 33% placebo, P=0.67). The post-CABG AF odds ratio for n3-PUFAs relative to placebo was 0.89 (95% confidence interval 0.52-1.53). There were no differences in any secondary end points.
  
  
  CONCLUSIONS
  Oral n3-PUFA supplementation begun 2 days before CABG did not reduce AF or other complications after surgery.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov Unique identifier: NCT00446966. (J Am Heart Assoc. 2012;1:e000547 doi: 10.1161/JAHA.111.000547.).
authors.affiliation: Virginia Cardiovascular Associates,  Manassas, VA (C.M.S.).
authors.forename: Chirag M
authors.initials: CM
authors.lastname: Sandesara
authors.forename: Mina K
authors.initials: MK
authors.lastname: Chung
authors.forename: David R
authors.initials: DR
authors.lastname: Van Wagoner
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Barringer
authors.forename: Keith
authors.initials: K
authors.lastname: Allen
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Ismail
authors.forename: Bridget
authors.initials: B
authors.lastname: Zimmerman
authors.forename: Brian
authors.initials: B
authors.lastname: Olshansky
keywords: atrial fibrillation; coronary artery bypass graft surgery; fatty acids