Omega-3 Fatty Acids in the Prevention of Atrial Fibrillation Recurrences after Cardioversion: A Meta-analysis of Randomized Controlled Trials

Abstract

Backgroud Previous randomized studies have reported conflicting results on the efficacy of omega-3 fatty acids in preventing atrial fibrillation (AF) recurrences after cardioversion. Objective A systematic review and meta-analysis of the role of omega-3 fatty acids in the prevention of atrial fibrillation recurrences after cardioversion was conducted. Methods PubMed, Cochrane Library, Elsevier, Science Online database were searched up to the end of January 2012 to identify all of the studies in human subjects that reported the effects of omega-3 fatty acids on the prevention of atrial fibrillation recurrences after cardioversion. Results Overall, omega-3 fatty acids had no significant effect on the prevention of AF recurrences after cardioversion (OR: 0.63,95% CI 0.35-1.13; p=0.12). The heterogeneity among the studies was significant (p= 0.01, I 2 =66%). Subgroup analysis showed that by administering omega-3 fatty acids at least 4 weeks prior to cardioversion and continuing thereafter, the recurrence rate of AF is significantly low (OR: 0.39, 95% CI 0.25-0.61; p<0.0001). Conclusion In the subgroup administered omega-3 fatty acids at least 4 weeks prior to cardioversion and continued thereafter, the recurrence rate of AF was significantly low. More double-blind, randomized, placebo-controlled, multicenter studies with high quality and longer follow-up periods are needed to affirm our conclusion.

N‐3 Polyunsaturated Fatty Acids to Prevent Atrial Fibrillation: Updated Systematic Review and Meta‐Analysis of Randomized Controlled Trials

“…Other systematic reviews had appraised the evidence on the effects of n‐3 PUFAs to prevent AF 23–25,48 with no definitive results, but our analysis, which more than doubled the number of patients and events, precludes any beneficial effects of n‐3 PUFAs for the prevention of secondary and postoperative AF.…”

“…The incorporation of a large and well-conducted clinical trial 47 provided strength to this systematic review, a characteristic that was not present in previous meta-analyses. [23][24][25] Other systematic reviews had appraised the evidence on the effects of n-3 PUFAs to prevent AF [23][24][25]48 with no definitive results, but our analysis, which more than doubled the number of patients and events, precludes any beneficial effects of n-3 PUFAs for the prevention of secondary and postoperative AF.…”

The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis

“…Some reviews and meta-analyses have demonstrated reductions in adverse events with both plant-based ALA and marine-sourced EPA and DHA supplementation in cardiovascular [9-14,39] and cerebrovascular disease [40], and marine omega-3 PUFA may be effective in preventing atrial fibrillation after cardiac surgery [41,42], although this finding remains controversial [43]. Other reviews have demonstrated mixed [6,15-18] or no benefits [19-21] following marine and/or plant-based omega-3 PUFA supplementation.…”

Novel Approach to the Prevention of Postoperative Atrial Fibrillation

“…Накопленные экспериментальные и клинические данные свидетельствуют о прямом антиаритмическом влиянии ПНЖК на кардиомиоциты и плейотропных эффектах в виде уменьшения выраженности окислительного стресса, противовоспалительной и антифибротической активности, которые в своей совокупности, вероятно, опосредуют дополнительный антиаритмический эффект [4,11]. Механизмы антиаритмического и антиокислительного действия ПНЖК взаимосвязаны и включают модификацию системы эйкозаноидов, модификацию состава жирных кислот мембраных фосфолипидов, прямое воздействие неэстерифицированных жирных кислот на миокард, влияние на иннозитол-липидный цикл и сигнальные системы, а также ионные транспортные системы [7,11].…”