Do omega-3 fatty acids increase risk of atrial fibrillation?

Abstract

Purpose of the reviewTo summarize the findings from recent observational follow-up studies and randomized trials of plant- and marine omega-3 fatty acids on the risk of atrial fibrillation (AF).Recent findingsRecent randomized cardiovascular outcome trials have indicated that supplements with marine omega-3 fatty acids may be associated with a higher risk of AF, and a meta-analysis has suggested that marine omega-3 fatty acid supplements were associated with a 25% higher relative risk of AF. Also, a recent large observational study reported a modest higher risk of AF in habitual users of marine omega-3 fatty acid supplements. However, recent observational biomarker studies of circulating and adipose tissue content of marine omega-3 fatty acids have in contrast reported a lower risk of AF. Very limited knowledge exists on the role of plant-derived omega-3 fatty acids and AF.SummaryMarine omega-3 fatty acid supplements may increase the risk of AF, whereas biomarkers reflecting consumption of marine omega-3 fatty acids have been linked to a lower risk of AF. Clinicians should inform patients that marine omega-3 fatty acid supplement may increase AF risk, and this should be taking into account when discussing pros and cons of taking supplements with marine omega-3 fatty acids.

Nutritional Insights: How Food Choices Affect Atrial Fibrillation

“…Clinical and experimental studies have shown that EPA and DHA supplementation may affect the stabilization of cardiomyocyte cell membranes by affecting ion channel proteins, which is crucial for proper cardiac electrophysiology. EPA and DHA can modulate the activity of sodium and potassium channels, which affects the length of the cardiac functional potential and the refractivity of the heart muscle, thereby reducing susceptibility to proarrhythmic conduction disorders [6,7,8].…”

“…Other studies have shown no statistically significant benefit of omega-3 supplementation in the prevention or treatment of AF. Such discrepancies may be due to differences in dosages, duration of supplementation, characteristics of study populations and different supplement formulations [7][8][9][10][11].…”

A rapid action plan to improve diagnosis and management of lipodystrophy syndromes

“…Although no studies are available in patients with lipodystrophies, a previous large-scale clinical study (68) reported cardiovascular benefits in patients with fasting triglyceride levels of 135-499 mg/dL following treatment with icosapent ethyl. However, the use of these agents may be limited in patients with lipodystrophies who are at higher risk of developing arrhythmias, as an increased risk of atrial fibrillation has been reported after the use of omega-3 fatty acids, particularly in high doses (69)(70)(71).…”

Editorial: Lipids to support physiology and function: both quantity and quality are important

“…A meta-analysis suggests that supplemental long chain n-3 PUFAs increase risk of atrial fibrillation [25], and a recent large observational study reported a modestly increased risk of atrial fibrillation in habitual users of n-3 PUFA supplements [26]. Bork et al [24] discuss candidate mechanisms for this potential adverse effect of n-3 PUFAs.…”

“…Nevertheless, and despite showing an overall benefit on mortality, some trials report an increased risk of atrial fibrillation with long chain n-3 PUFAs [23]. Bork et al [24] discuss this further. A meta-analysis suggests that supplemental long chain n-3 PUFAs increase risk of atrial fibrillation [25], and a recent large observational study reported a modestly increased risk of atrial fibrillation in habitual users of n-3 PUFA supplements [26].…”