Abstract
Previous studies had suggested that Omega-3 fatty acids have pleiotropic effects and favourable safety profile, which may potentially increase the efficacy of antiarrhythmic drugs in suppressing atrial arrhythmias through combination therapy. This meta-analysis aimed to determine the effectiveness of using Omega-3 polyunsaturated fatty acids as a sole anti-arrhythmic agent or as an adjunct to existing pharmacological therapies in preventing atrial fibrillation recurrence. Randomized controlled trials published in English, from inception to December 2016, were considered. We searched for published studies in the following electronic databases: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature. Pooled hazard ratio (HR) and corresponding 95% confidence intervals (CI) for time to first atrial fibrillation recurrence was analysed using a fixed effects model. Four RCTs with 1,268 participants were included in the review. Our results showed that Omega-3 polyunsaturated fatty acid therapy had no effect on preventing atrial fibrillation recurrence compared to control/placebo group (HR: 1.13, 95% CI: 0.96 to 1.33, p = 0.14), with no significant heterogeneity found among those studies (Q value = 0.15, 9 = 0.99, I2 = 0%). Therefore, current evidence does not support treatment benefit of Omega-3 fatty acids in preventing atrial fibrillation recurrence among patients who have not been treated by any conventional reversion treatment, or who have only been treated with pharmacological therapy.
Highlights
Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia affecting approximately 33.5 million individuals worldwide [1]
Four Randomized controlled trials (RCTs) studies were included for this meta-analysis [15, 17, 22, 23]
Omega-3 polyunsaturated fatty acid therapy had no effect www.impactjournals.com/oncotarget in preventing AF recurrence compared to control/placebo group (HR: 1.13, 95% confidence intervals (CI): 0.96 to 1.33, p = 0.14), with no significant heterogeneity found among those studies (Q value = 0.15, 9 = 0.99, I2 = 0%)
Summary
Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia affecting approximately 33.5 million individuals worldwide [1]. Well tolerated in most patients, AF is associated with an increased longterm risk of stroke and all-cause mortality [2]. Common treatment options to restore sinus rhythm (SR), otherwise known as rhythm control, consist of both pharmacological and non-pharmacological strategies, of which the latter includes electrical cardioversion, catheter ablation and surgical ablation [4]. Evidence support the efficacy of non-pharmacological methods in rhythm control, the recurrence rate of AF after treatment with non-pharmacological strategies remains high [5]. The invasive nature of non-pharmacological interventions is associated with www.impactjournals.com/oncotarget poorer tolerability, higher costs [6], and concerns about the risk of life-threatening complications such as pericardial tamponade [4, 7]. Antiarrhythmic drugs (AADs) may be preferred in reducing cost and promoting ease of treatment
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