Omega-3 fatty acid supplementation does not reduce risk
of atrial fibrillation after coronary artery bypass surgery:
a randomized, double-blind, placebo-controlled clinical trial
Background—Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been reported to reduce the risk of sudden cardiac
death presumed to be due to fatal ventricular arrhythmias, but their effect on atrial arrhythmias is unclear.
Methods and Results—Patients (n108) undergoing coronary artery bypass graft surgery were randomly assigned to
receive 2 g/d n-3 PUFA or placebo (olive oil) for at least 5 days before surgery (median, 16 days; range, 12 to 21
days). Phospholipid n-3 PUFA were measured in serum at study entry and at surgery and in right atrial appendage
tissue at surgery. Echocardiography was used to assess left ventricular function and left atrial dimensions.
Postoperative continuous ECG monitoring (Lifecard CF) for 5 days or until discharge, if earlier, was performed
with a daily 12-lead ECG and clinical review if patients remained in the hospital beyond 5 days. Lifecard
recordings were analyzed for episodes of atrial fibrillation (AF) 30 seconds (primary outcome). Clinical AF, AF
burden (% time in AF), hospital stay, and intensive care/high dependency care stay were measured as secondary
outcomes. One hundred three patients completed the study (51 in the placebo group and 52 in the n-3 PUFA group).
There were no clinically relevant differences in baseline characteristics between groups. n-3 PUFA levels were
higher in serum and right atrial tissue in the active treatment group. There was no significant difference between
groups in the primary outcome of AF (95% confidence interval [CI], 6% to 30%, P0.28) in any of the
secondary outcomes or in AF-free survival.
Conclusions—Omega-3 PUFA do not reduce the risk of AF after coronary artery bypass graft surgery
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