title: Effects of long-term ω-3 polyunsaturated fatty acid supplementation on paroxysmal atrial tachyarrhythmia burden in patients with implanted pacemakers: results from a prospective randomised study.
abstract: BACKGROUND
  Sino-atrial node disease and aging increase AF risk. We investigated if long-term fish oil supplementation reduces paroxysmal atrial tachycardia/fibrillation (AT/AF) burden in patients aged ≥60 years with sinoatrial node disease and dual chamber pacemakers.
  
  
  METHODS
  Following a run-in period of 6 months (p1) where AT/AF burden was logged,78 patients were randomised to control or fish oil group (total omega-3 6 g/d) and AT/AF burden evaluated after 6 months (p2; 39 controls, 39 fish oil) and 12 months (p3; 39 controls; 18 fish oil). A subset of 21 fish oil patients crossed over to controls in the final 6 months (crossover group).
  
  
  RESULTS
  Median AT/AF burden increased significantly in controls (1.5%, 3.2%, 4.3%, P<.001) but not in fish oil patients at 6 months (1.4% to 2%, P=.46) or those continuing for 12 months (1.5%, 0.98%, 1%, P=.16). Time to first episode of AT/AF >1 min was not significantly different between the groups (P=.9). There was a rebound increase in AT/AF burden in p3 in cross over patients (2.2% to 5.8%, P=.01) reaching a level similar to controls (crossover vs. controls, 5.8% vs. 4.3%, P=.63) and higher than those who continued fish oil for 12 months (crossover vs. continued intake 5.8% vs. 1.2%, P=.02). Fish oil patients had shorter duration episodes of AT/AF with no difference in frequency compared to controls.
  
  
  CONCLUSIONS
  Long-term fish oil supplementation did not suppress AT/AF burden but may have attenuated its temporal progression related to aging and sinus node disease.
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.forename: Fiona
authors.initials: F
authors.lastname: Sutherland
authors.forename: Irene
authors.initials: I
authors.lastname: Stevenson
authors.forename: Justin M S
authors.initials: JM
authors.lastname: Lee
authors.forename: Manohar L
authors.initials: ML
authors.lastname: Garg
authors.forename: Paul B
authors.initials: PB
authors.lastname: Sparks
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000178:diet therapy* / Q000453:epidemiology; D002304:Cardiac Pacing, Artificial / Q000639:trends*; D015331:Cohort Studies; D018592:Cross-Over Studies; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000639:trends*; D011446:Prospective Studies; D013610:Tachycardia / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3
keywords: Atrial fibrillation; Atrial flutter; Fish oil; Omega-3 polyunsaturated fatty acids; Permanent pacemakers; Sinus node dysfunction