Effects of long-term omega-3 polyunsaturated fatty acid supplementation on paroxysmal atrial tachyarrhythmia burden in patients with implanted pacemakers: Results from a prospective randomised study

Abstract Background Sino-atrial node disease and aging increase AF risk. We investigated if long-term fish oil supplementation reduces paroxysmal atrial tachycardia/fibrillation (AT/AF) burden in patients aged ≥60years with sinoatrial node disease and dual chamber pacemakers. Methods Following a run-in period of 6months (p1) where AT/AF burden was logged,78 patients were randomised to control or fish oil group(total omega-3 6g/d) and AT/AF burden evaluated after 6months(p2; 39 controls, 39 fish oil) and 12months (p3; 39 controls; 18 fish oil). A subset of 21 fish oil patients crossed over to controls in the final 6months (crossover group). Results Median AT/AF burden increased significantly in controls (1.5%, 3.2%, 4.3%, P P =.46) or those continuing for 12months (1.5%, 0.98%, 1%, P =.16). Time to first episode of AT/AF >1min was not significantly different between the groups ( P =.9). There was a rebound increase in AT/AF burden in p3 in cross over patients (2.2% to 5.8%, P =.01) reaching a level similar to controls (crossover vs. controls, 5.8% vs. 4.3%, P =.63) and higher than those who continued fish oil for 12months (crossover vs. continued intake 5.8% vs. 1.2%, P =.02). Fish oil patients had shorter duration episodes of AT/AF with no difference in frequency compared to controls. Conclusion Long-term fish oil supplementation did not suppress AT/AF burden but may have attenuated its temporal progression related to aging and sinus node disease.