Are There the Antiarrhythmic Effects of Omega3 Polyunsaturated Fatty Acids in Cardiosurgical Patients?

Objective: to test the hypothesis that the perioperative use of omega3 polyunsaturated fatty acids (ω3PUFA) as intravenous infusion will reduce the risk of postoperative atrial fibrillation (POAF) in patients with coronary heart disease operated on under extracorporeal circulation.

Subjects and methods. A doubleblind prospective controlled study was conducted in 39 patients who were randomized into two groups: 1) 18 patients were infused with ω3PUFA (Omegaven, Fresenius Kabi, Germany), beginning before inducing anesthesia in a dose of 200 mg/kg/day within the first 24 hours and 100 mg/kg/day on days 2 to 7 postsurgery; 2) 21 received placebo (Intralipid, Fresenius Kabi, Germany) in the equivalent dose. The primary end point was freedom from POAF during 2 months after surgery. POAF was examined using a subcutaneously implanted continuous cardiac rhythm monitoring device (Reveal XT, Medtronic, USA). Monitoring readings were taken on day 10 at 3, 6, 12, and 24 months following surgery.

Results. POAF was observed in 4 (19%) patients in the placebo group and in 5 (27.8%) in the ω3PUFA group on days 10 postsurgery (p=0.88). During 2year followup, POAF was revealed in 5 (27.8%) patients in the control group and in 6 (35.3%) in the ω3PUFA group (p=0.9). The duration of POAF was associated with the risk of rehospitalizations for decompensated heart failure (regression coefficient, 0.24; standard error, 0.02; p<0.0001; R2=0.74).

Conclusion. The results of the study do not support the efficiency of perioperatively using ω3PUFA to prevent POAF

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