Abstract 14854: Chronic Fish Oil Supplementation in Humans Reduces the Recurrence of Persistent Atrial Fibrillation after Cardioversion
Introduction: Pre clinical studies suggest that fish oils attenuate atrial structural remodelling in atrial fibrillation (AF) and thus may be anti-fibrillatory.
Hypothesis: We hypothesised that chronic fish oil supplementation would reduce the recurrence of persistent AF after cardioversion.
Methods: Patients with persistent AF were randomised in an open label fashion to a control group (n=76) or a fish oil group (n=76); the latter were prescribed 6g/d of fish oil for >1 month prior to cardioversion and continued till return of AF or up to maximum of 1 year. Concurrent anti-arrhythmic use with sotalol or amiodarone was permitted. Primary endpoint was recurrence of AF. Clinical and ECG follow up was at 2 weeks, 6 weeks, and 3 monthly intervals after cardioversion and during intervening periods if return of AF was suspected.
Results: Mean duration of fish oil supplementation was 70 days. AF recurred in 63.4% of controls versus 32.2% of fish oil patients at 90 days and in 85.5% of controls versus 64% of fish oil patients at 1 year. Mean time to AF recurrence was 126 days in controls vs. 311 days in fish oil patients (P<0.001). After adjusting for baseline risk, fish oil use was associated with a significant reduction in the risk of recurrent AF (adjusted hazard ratio [HR] fish oil vs. control 0.48; P<0.001). Fish oil without concurrent anti-arrhythmic drugs (adjusted HR 0.36, 95% CI 0.15-0.87, P=0.02 for fish oil vs. control) or in combination with anti-arrhythmic drugs reduced recurrence of persistent AF (HR 0.5, 95% CI 0.27-0.9 for sotalol + fish oil vs. sotalol alone, P=0.02; HR 0.39, 95% CI 0.16-0.95, for amiodarone + fish oil vs. amiodarone alone, P=0.04).
Conclusion: Chronic fish oil supplementation (>1 month) prior to cardioversion of persistent AF and continued thereafter reduces recurrences of persistent AF. Future randomised trials on long term fish oil supplementation are needed to confirm these findings.
- © 2011 by American Heart Association, Inc.