Saravanan P, Bridgewater B, West AL, et al. Omega-3 Fatty Acid Supplementation Does Not Reduce Risk of Atrial Fibrillation Following Coronary Artery Bypass Surgery: A Randomized, Double Blind, Placebo Controlled Clinical Trial. Circ Arrhythm Electrophysiol published 30 December 2009,
doi 10.1161/CIRCEP.109.899633
http://circep.ahajournals.org/cgi/content/abstract/CIRCEP.109.899633v1
http://circep.ahajournals.org/cgi/rapidpdf/CIRCEP.109.899633v1
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Published Online
on December 30, 2009
Circulation: Arrhythmia and Electrophysiology. 2009
Published online before print December 30, 2009, doi: 10.1161/CIRCEP.109.899633
Original Article
Omega-3 Fatty Acid Supplementation Does Not Reduce Risk of Atrial Fibrillation Following Coronary Artery Bypass Surgery: A Randomized, Double Blind, Placebo Controlled Clinical Trial
Palaniappan Saravanan1,5; Ben Bridgewater2; Annette L. West3; Stephen C. O'Neill4; Philip C. Calder3 and Neil C. Davidson2
1 University of Manchester & University Hospital of South Manchester, Manchester, United Kingdom;
2 University Hospital of South Manchester, Manchester, United Kingdom;
3 University of Southampton, Southampton, United Kingdom;
4 University of Manchester, Manchester, United Kingdom
* Corresponding author; email: palaniappan.saravanan@manchester.ac.uk
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 (n = 108) undergoing CABG surgery were randomized to receive 2 g/day n-3 PUFA or placebo (olive oil) for at least 5 days prior to surgery (median;16 days, range;12-21 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. Post-operative 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 hospital beyond 5 days. Lifecard recordings were analyzed for episodes of atrial fibrillation 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. 103 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%, p=0.28), in any of the secondary outcomes or in AF free survival.
Conclusion—Omega-3 PUFA do not reduce the risk of AF following CABG.
Clinical Trial Registration Information—www.ukcrn.org.uk, Trial identifier: 4437.
Key Words: atrial fibrillation • coronary artery by-pass graft surgery • fish oil • inflammation • n-3 PUFA
Copyright © 2009 American Heart Association, Inc. All rights reserved.