Thursday, November 18, 2010
AF atrial fibrilation
4.
Omega-3 Fatty Acids and Atrial Fibrillation
In a short-term, randomized, controlled trial, a prescription-strength fish oil supplement failed to prevent AF recurrence.
Because fish oil has been shown to have direct electrophysiologic effects on the cell membrane as well as anti-inflammatory and autonomic-modulating properties, many clinicians are convinced of its efficacy in treating atrial fibrillation (AF), despite mixed findings from various studies. In a manufacturer-sponsored, randomized, control trial, 584 patients with paroxysmal (n=479) or persistent (n=105) AF received either 4 g/day of a prescription formulation of omega-3 fatty acids or placebo. At baseline, no participants were taking antiarrhythmic drugs, and all were free of structural heart disease and in normal sinus rhythm.
During 24 weeks of follow-up, symptomatic AF recurred in 46% of patients in the placebo group and in 52% of those in the omega-3 group, a nonsignificant difference. The results were consistent in both the paroxysmal and persistent subgroups. Compared with the placebo group, the omega-3 group had significantly greater on-treatment reductions in mean triglyceride level and systolic blood pressure and in median hemoglobin A1C level.
Comment: Herbal and dietary supplements are rarely tested in randomized controlled trials, largely because of a lack of industry funding. In this well-designed and -managed trial, fish oil did not prevent AF during a relatively short follow-up. However, any beneficial effects of fish oils likely require much longer than 6 months of administration, and indeed the physiologic outcomes suggest a potential benefit. Nonetheless, in the absence of larger, longer-term trial results, adding another prescription medication to the daily regimen of patients with AF is difficult to justify.
— Mark S. Link, MD
Published in Journal Watch Cardiology November 15, 2010
Omega-3 Fatty Acids and Atrial Fibrillation
In a short-term, randomized, controlled trial, a prescription-strength fish oil supplement failed to prevent AF recurrence.
Because fish oil has been shown to have direct electrophysiologic effects on the cell membrane as well as anti-inflammatory and autonomic-modulating properties, many clinicians are convinced of its efficacy in treating atrial fibrillation (AF), despite mixed findings from various studies. In a manufacturer-sponsored, randomized, control trial, 584 patients with paroxysmal (n=479) or persistent (n=105) AF received either 4 g/day of a prescription formulation of omega-3 fatty acids or placebo. At baseline, no participants were taking antiarrhythmic drugs, and all were free of structural heart disease and in normal sinus rhythm.
During 24 weeks of follow-up, symptomatic AF recurred in 46% of patients in the placebo group and in 52% of those in the omega-3 group, a nonsignificant difference. The results were consistent in both the paroxysmal and persistent subgroups. Compared with the placebo group, the omega-3 group had significantly greater on-treatment reductions in mean triglyceride level and systolic blood pressure and in median hemoglobin A1C level.
Comment: Herbal and dietary supplements are rarely tested in randomized controlled trials, largely because of a lack of industry funding. In this well-designed and -managed trial, fish oil did not prevent AF during a relatively short follow-up. However, any beneficial effects of fish oils likely require much longer than 6 months of administration, and indeed the physiologic outcomes suggest a potential benefit. Nonetheless, in the absence of larger, longer-term trial results, adding another prescription medication to the daily regimen of patients with AF is difficult to justify.
— Mark S. Link, MD
Published in Journal Watch Cardiology November 15, 2010
# posted by roodbont @ 2:05 AM 
