N-3 polyunsaturated fatty acids in the prevention of atrial fibrillation recurrences after electrical cardioversion: A prospective, randomized study

Savina Nodari, Marco Triggiani, Umberto Campia, Alessandra Manerba, Giuseppe Milesi, Bruno M. Cesana, Mihai Gheorghiade, Livio Dei Cas*

*Corresponding author for this work

Research output: Contribution to journalArticle

88 Scopus citations

Abstract

BACKGROUND-: n-3 polyunsaturated fatty acids (n-3 PUFAs) exert antiarrhythmic effects and reduce sudden cardiac death. However, their role in the prevention of atrial fibrillation remains controversial. We aimed to determine the effect of n-3 PUFAs in addition to amiodarone and a renin-angiotensin-aldosterone system inhibitor on the maintenance of sinus rhythm after direct current cardioversion in patients with persistent atrial fibrillation. METHODS AND RESULTS-: We conducted a randomized, double-blind, placebo-controlled, parallel-arm trial in patients with persistent atrial fibrillation, with at least 1 relapse after cardioversion, and treated with amiodarone and a renin-angiotensin-aldosterone system inhibitor. Participants were assigned to placebo or n-3 PUFAs 2 g/d and then underwent direct current cardioversion 4 weeks later. The primary end point was the probability of maintenance of sinus rhythm at 1 year after cardioversion. Of 254 screened patients, 199 were found to be eligible and randomized. At the 1-year follow up, the probability of maintenance of sinus rhythm was significantly higher in the n-3 PUFAs-treated patients compared with the placebo group (hazard ratio, 0.62 [95% confidence interval, 0.52 to 0.72] and 0.36 [95% confidence interval, 0.26 to 0.46], respectively; P=0.0001). CONCLUSIONS-: In patients with persistent atrial fibrillation on amiodarone and a renin-angiotensin-aldosterone system inhibitor, the addition of n-3 PUFAs 2 g/d improves the probability of the maintenance of sinus rhythm after direct current cardioversion. Our data suggest that n-3 PUFAs may exert beneficial effects in the prevention of atrial fibrillation recurrence. Further studies are needed to confirm and expand our findings.

Original languageEnglish (US)
Pages (from-to)1100-1106
Number of pages7
JournalCirculation
Volume124
Issue number10
DOIs
StatePublished - Sep 6 2011

Keywords

  • arrhythmia
  • atrial fibrillation
  • cardioversion
  • fatty acids, omega-3
  • recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Nodari, S., Triggiani, M., Campia, U., Manerba, A., Milesi, G., Cesana, B. M., Gheorghiade, M., & Dei Cas, L. (2011). N-3 polyunsaturated fatty acids in the prevention of atrial fibrillation recurrences after electrical cardioversion: A prospective, randomized study. Circulation, 124(10), 1100-1106. https://doi.org/10.1161/CIRCULATIONAHA.111.022194