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JACC March 9, 2010
Volume 55, issue 10A
N-3 POLY-UNSATURATED FATTY ACIDS FOR THE PREVENTION OF ATRIAL FIBRILLATION RECURRENCE
AFTER ELECTRICAL CARDIOVERSION OF CHRONIC PERSISTENT ATRIAL FIBRILLATION. A RANDOMIZED,
DOUBLE-BLIND, MULTICENTRE STUDY.
ACC Poster Contributions
Georgia World Congress Center, Hall B5
Sunday, March 14, 2010, 3:30 p.m.-4:30 p.m.
Session Title: Clinical Electrophysiology--Supraventricular Arrhythmias
Abstract Category: Clinical Electrophysiology--Supraventricular Arrhythmias
Presentation Number: 1081-152
Authors: Leopoldo Bianconi, Leonardo Calò, Silvia Mennuni, Luca Santini, Paolo Morosetti, Paolo Azzolini, Giuseppe Barbato, Francesco Biscione,
Paolo Romano, Massimo Santini, Rome, Italy
Background: Persistent atrial fibrillation (AF) can be successfully terminated by Direct Current electrical cardioversion (ECV). However the
arrhythmia recurs in the majority of the cases despite treatment with antiarrhythmic drugs. Several experimental and clinical studies showed that
n-3 poly-unsaturated fatty acids (PUFAs) could have antiarrhythmic properties even at atrial level. The aim of this multicentre study was to assess if
oral PUFAs supplementation in patients undergoing ECV for persistent AF could reduce the recurrence rate of the arrhythmia.
Methods: A total of 204 patients (mean age 69.3 years, 33% females) with persistent AF were double blindly randomized to receive 2 grams a day
of PUFAs (104 patients) or placebo (100 patients), beginning at least one week before ECV until the end of the study. The use of other antiarrhythmic
drugs was left to the local medical decision. All the patients were followed up for 6 months and their rhythm was assessed both by trans-telephonic
monitoring and clinical visits. Primary end point was the recurrence rate of AF.
Results: After ECV (in case of a first unsuccessful ECV a second one could be attempted after modification of antiarrhythmic treatment) 187
patients (91.7%) were in sinus rhythm: 95 (91.4%) patients on PUFAs and 92 (92.0%) patients on placebo (p=NS). Atrial fibrillation relapsed in 56
(58.9%) of the PUFAs patients and in 47 (51.1%) of the placebo patients (p=0.28). The mean time to AF recurrence was 83+8 days in the PUFAs
group and 106+9 days in the placebo group (p=0.29). The absence of difference between the two groups of patients in the arrhythmia recurrence
was present both in patients off and on antiarrhythmic drugs, independently of the type of drug.
Conclusions: PUFAs supplementation at a dose of 2 grams a day, on top of standard antiarrhythmic treatment, in patients undergoing ECV of
chronic persistent AF was not able to reduce the recurrence of the arrhythmia.