RG Metcalf¹, A Farquharson², GD Young¹, R Stuklis¹, JRM Edwards¹, P Sanders², RA Gibson², LG Cleland¹, MJ James^1
1Royal Adelaide Hospital, Adelaide, Australia
²University of Adelaide, Adelaide, Australia

Objective: To examine the effects of dietary fish oil on the incidence of atrial fibrillation (AF) post cardiac surgery (coronary artery bypass grafting and/or valve repair/replacement). Procedure: 200 participants were randomly allocated to ingest 15 mL citrus-flavoured fish oil (18%EPA, 12%DHA) or sunola oil (monounsaturated) each day commencing 3 weeks before the scheduled surgery date. The oils were continued during the post-operative in-patient period. The primary outcome measure was incidence of AF of at least 10 min duration or requiring intervention during the first 6 post-operative days or until discharge if earlier. This measure was assessed independently by two investigators. The primary endpoint was assessed by Fisher’s Exact Test and was analysed on an intention-to-treat basis. Time to first episode of AF was assessed by Kaplan-Meier analysis and Log-rank test.

Results: 189 subjects completed the study (95 in the treatment group and 94 in the placebo group).The overall incidence of AF was 41.3%, with 35.8% in the treatment group and 46.8% in the placebo group (p=0.14, Fisher’s Exact Test, RR 0.76, 95% CI: 0.54 to 1.08). Kaplan-Meier analysis showed fish oil supplementation resulted in a non-significant reduction in the time to first event (p = 0.11, log-rank test).

Conclusion: Fish oil was associated with a non-significant reduction in the incidence of post-operative AF.

Keywords: omega-3 fatty acids, post-operative AF, fish oil, post cardiac surgery
Schlüsselwörter: Omega-3 Fettsäuren, postoperativen Vorhofflimmern (VHF), Alphalinolensäure (ALA)