title: Randomized trial of fish oil infusion to prevent atrial fibrillation after cardiac surgery: data from an implantable continuous cardiac monitor.
abstract: OBJECTIVE
  To test the hypothesis that perioperative OMEGA-3 polyunsaturated fatty acid infusion would reduce the incidence of postoperative atrial fibrillation in patients after coronary artery bypass grafting as assessed by an implantable continuous cardiac monitor.
  
  
  METHODS
  Prospective, randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Tertiary cardiothoracic referral center.
  
  
  METHODS
  Thirty-nine patients with coronary artery disease who underwent surgery with cardiopulmonary bypass.
  
  
  METHODS
  Patients were assigned randomly to receive either OMEGA-3 polyunsaturated fatty acids (200 mg/kg/day starting before anesthesia induction for 24 hours followed by 100 mg/kg/day for 7 days) or placebo. The primary outcome was freedom from atrial fibrillation at 2-year follow-up. Reveal(®) cardiac monitor was implanted subcutaneously in all patients. Data from the cardiac monitor were collected on the 10th day and 3, 6, 12, and 24 months postoperatively.
  
  
  RESULTS
  Postoperative atrial fibrillation developed in 4 (19%) patients in the control group and in 5 (27.8%) patients in the study group at 10-day follow-up (p = 0.88). At 2-year follow-up, 5 (27.8%) patients in the control group and 6 (35.3%) patients in the study group had atrial fibrillation (p = 0.9). Atrial fibrillation duration predicted risk of cardiovascular hospitalization at the 2-year follow-up (regression coefficient estimate = 0.24, standard error 0.02, p<0.0001; R(2) = 0.74).
  
  
  CONCLUSIONS
  Infusion of OMEGA-3 polyunsaturated fatty acids failed to prevent the occurrence of atrial fibrillation in 2 years after coronary artery bypass grafting surgery. The cumulative atrial fibrillation duration registered by the continuous cardiac monitor at the 2-year follow-up was a significant predictor of an adverse outcome.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russia. Electronic address: v.lomivorotov@gmail.com.
authors.forename: Vladimir V
authors.initials: VV
authors.lastname: Lomivorotov
authors.affiliation: Department of Anaesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Sergey M
authors.initials: SM
authors.lastname: Efremov
authors.affiliation: Department of Arrhythmia, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Eugeniy A
authors.initials: EA
authors.lastname: Pokushalov
authors.affiliation: Department of Arrhythmia, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Romanov
authors.affiliation: Department of Anaesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Dmitriy N
authors.initials: DN
authors.lastname: Ponomarev
authors.affiliation: Department of Cardiac Surgery, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Cherniavsky
authors.affiliation: Laboratory of Biochemistry, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Anna N
authors.initials: AN
authors.lastname: Shilova
authors.affiliation: Department of Cardiac Surgery, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Karaskov
authors.affiliation: Department of Anaesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Lomivorotov
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000639:trends; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils
keywords: atrial fibrillation; cardiopulmonary bypass; coronary artery bypass grafting; omega-3 polyunsaturated fatty acids