Abstract
Marine n−3 polyunsaturated fatty acids (PUFA) may have beneficial effects in relation to atrial fibrillation (AF) with promising data from experimental animal studies, however, results from studies in humans have been inconsistent. This review evaluates the mechanisms of action of marine n−3 PUFA in relation to AF based on experimental data and provides a status on the evidence obtained from observational studies and interventional trials. In conclusion, there is growing evidence for an effect of marine n−3 PUFA in prevention and treatment of AF. However, further studies are needed to establish which patients are more likely to benefit from n−3 PUFA, the timing of treatment, and dosages.
Highlights
Faced with the growing epidemic of atrial fibrillation (AF), there is an unmet need for preventive measures as well as better treatment of this disorder
In some studies marine n−3 polyunsaturated fatty acids (PUFA) have lowered the risk of sudden cardiac death (De Caterina, 2011; Mozaffarian and Wu, 2011) and in turn, these observed effects on ventricular tachyarrhythmia have lead to research into potential effects of n−3 PUFA on atrial rhythm disturbances including AF
The n−3 PUFA family consists of alpha-linolenic acid (ALA) derived from plants and the marine n−3 PUFA consisting of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA)
Summary
Faced with the growing epidemic of atrial fibrillation (AF), there is an unmet need for preventive measures as well as better treatment of this disorder. Some of the advances in recent years have been on rhythm control to restore sinus rhythm, but the development of effective and safe drugs for restoring sinus rhythm has been difficult, trying to balance beneficial anti-arrhythmic effects with risk of pro-arrhythmic adverse effects. Invasive intervention by catheter ablation techniques and surgery may be more effective, but is an option mostly for highly symptomatic patients, given the risk of peri-procedure complications and high costs. Fish consumption and intake of marine n−3 polyunsaturated fatty acids (PUFA), with suggested anti-arrhythmic effects in relation to malignant ventricular arrhythmias, is safe and with few side-effects. This review will discuss the mechanisms of action of marine n−3 PUFA in relation to AF based on experimental data and provide a status on the evidence of the effect of marine n−3 PUFA in AF as obtained from observational studies and interventional trials
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