Omega-3 Fatty Acids for the Prevention of Recurrent Atrial Fibrillation - Omega-3 Fatty Acids for the Prevention of Recurrent Atrial Fibrillation
The goal of the trial was to evaluate treatment with prescription omega-3 fatty acids compared with placebo among patients with symptomatic paroxysmal or persistent atrial fibrillation (AF).
Prescription omega-3 fatty acids will be more effective in preventing recurrence of AF.
- Placebo Controlled
- Patients at least 18 years of age with symptomatic paroxysmal or persistent AF
Number of enrollees: 663
Duration of follow-up: 6 months
Mean patient age: 61 years
Percentage female: 44%
- Permanent AF
- Secondary AF due to hypothyroidism or valvular heart disease
- Current use of antiarrhythmic therapy
- Use of amiodarone within the last 6 months
- Prior ablation therapy for AF
- Structural heart disease
- First symptomatic recurrence of AF in patients with paroxysmal AF
- First symptomatic recurrence of AF in patients with persistent AF
Patients with symptomatic paroxysmal or persistent AF were randomized to prescription omega-3 fatty acids: 8 g daily for the first week, then 4 g daily (n = 332) versus placebo (n = 331).
At baseline, 39% of participants were receiving an angiotensin-converting enzymeinhibitor/angiotensin-receptor blocker, and 45% were receiving a statin.
Overall, 663 patients were randomized. The mean age of participants was 61 years, 44% were women, mean body mass index was 31 kg/m2, and paroxysmal AF was present in 82%.
The primary outcome, first recurrence of symptomatic AF/flutter in patients with paroxysmal AF occurred in 52% of the omega-3 group versus 48% of the placebo group (p = 0.26).
The secondary outcome, first recurrence of symptomatic AF/flutter in patients with persistent AF occurred in 50% versus 33% (p = 0.09), and the first recurrence of symptomatic AF/flutter among all patients occurred in 52% versus 46% (p = 0.08), respectively.
Eicosapentaenoic and docosahexaenoic acid blood levels were significantly higher in the omega-3 group versus the placebo group at 24 weeks (p < 0.001).
Among patients with paroxysmal or persistent AF, treatment with omega-3 fatty acids was not effective in preventing symptomatic recurrence of AF. Prevention of AF remains a difficult clinical problem. The findings of this relatively large trial do not support the results of previous observational and smaller clinical trials.
Kowey PR, Reiffel JA, Ellenbogen KA, Naccarelli GV, Pratt CM. Efficacy and safety of prescription omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: a randomized controlled trial. JAMA 2010;Nov 15:[Epub ahead of print].
Presented by Dr. Peter Kowey at the American Heart Association Scientific Sessions, Chicago, IL, November 15, 2010.
Keywords: Follow-Up Studies, Body Mass Index, Fatty Acids, Omega-3, Docosahexaenoic Acids
< Back to Listings