N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation after electrical cardioversion: A prospective randomized study

Department of Cardiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology (Impact Factor: 0.93). 06/2011; 11(4):305-9. DOI: 10.5152/akd.2011.080
Source: PubMed


The purpose of the present prospective randomized study was to evaluate the effects of n-3 polyunsaturated fatty acids on recurrence rates of atrial fibrillation (AF) and inflammation after electrical cardioversion.
Calculation of the number of patients needed was based on the assumption of 20% and 65% chance of maintaining sinus rhythm with amiodarone and with polyunsaturated fatty acids, respectively. To observe a significant difference with an alpha level of 0.05 and a power of 0.80 it was necessary to include 22 patients in each group. A total of 47 patients were randomized to amiodarone (n=24) and amiodarone plus n-3 polyunsaturated fatty acids (n=23) groups before scheduled electrical cardioversion. The end-point was the recurrence of AF during 12-month follow-up. Effect of n-3 polyunsaturated fatty acids on inflammation was evaluated with high sensitivity C-reactive protein level measurements. Statistical analysis was performed using unpaired Student' t, Mann Whitney U and Chi-square tests. We analyzed the recurrence of AF using the Cox proportional hazards regression model to control for potentially confounding factors.
Nine patients in the amiodarone group (37.5%), and 9 patients in the amiodarone plus n-3 polyunsaturated fatty acids group (39.1%) had recurrence of AF during follow-up (p=1). With the Cox proportional model, risk factors for the recurrence of AF were previous electrical cardioversion (HR 10.33, 95% CI 1.74 to 61.10, p=0.01) and high sensitivity C-reactive protein levels (HR 1.07, 95% CI 1.02 to 1.38, p=0.007). High sensitivity C-reactive protein levels at baseline, at day 15 and during AF recurrence were similar between two groups (p > 0.05 for all).
N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation.

Download full-text


Available from: Abdullah Dogan
  • Source
    • "Recently, a number of RCT has been reported (Table 2), of which two showed a beneficial effect of treatment with marine n−3 PUFA (Nodari et al., 2011; Kumar et al., 2012), whereas this was not found in three other studies (Kowey et al., 2010; Bianconi et al., 2011; Ozaydin et al., 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Marine n-3 polyunsaturated fatty acids (PUFA) may have beneficial effects in relation to atrial fibrillation (AF) with promising data from experimental animal studies, however, results from studies in humans have been inconsistent. This review evaluates the mechanisms of action of marine n-3 PUFA in relation to AF based on experimental data and provides a status on the evidence obtained from observational studies and interventional trials. In conclusion, there is growing evidence for an effect of marine n-3 PUFA in prevention and treatment of AF. However, further studies are needed to establish which patients are more likely to benefit from n-3 PUFA, the timing of treatment, and dosages.
    Preview · Article · May 2012 · Frontiers in Physiology
  • Source

    Preview · Article · Sep 2011 · Circulation
  • [Show abstract] [Hide abstract]
    ABSTRACT: Atrial fibrillation (AF) is associated with higher health care costs. Although omega-3 (n-3) fatty acids have been associated with a decreased risk of coronary heart disease, their effects on the risk of AF are inconsistent. We therefore sought to review the relation between n-3 fatty acids and the risk of AF. Using an extensive online search, we conducted a meta-analysis of new onset incident/recurrent AF following exposure to fish/fish oil or long-chain n-3 polyunsaturated fatty acids. A random-effect model was used and between-studies heterogeneity was estimated with I(2). The quality of studies was assessed using Jadad and United States Preventive Services Task Force (USPSTF) scoring systems. All analyses were performed with RevMan (version 5.0.20). Seven cohort studies and 11 randomized controlled trials (RCTs) were included in this meta-analysis. The pooled odds ratio (OR) was 0.79 (95% confidence interval [CI] = 0.56-1.12; p = 0.19) for RCTs and 0.83 (95% CI = 0.59-1.16; p = 0.27) for cohort studies. On sensitivity analysis, no statistically significant difference was noted when stratified by study design or quality of the studies (as graded by Jadad or USPSTF scoring systems). This study does not suggest a major effect of fish/fish oil or n-3 fatty acids on the risk of AF.
    No preview · Article · Feb 2012 · Journal of the American College of Nutrition
Show more