Prevention of atrial fibrillation with omega-3 fatty acids: a meta-analysis of randomised clinical trials

CONTEXT: Previous randomised controlled trials (RCT) regarding n-3 PUFA supplementation for atrial fibrillation (AF) prevention have yielded conflicting results. OBJECTIVE: A systematic review and meta-analysis of RCT was conducted to examine the role of n-3 PUFA in AF prevention. DATA SOURCES: MEDLINE, Web of Science and Cochrane clinical trials database were searched until November 2010. STUDY SELECTION: Of 127 initially identified studies, 10 RCT with 1955 patients were finally analysed. DATA EXTRACTION: Two blinded reviewers extracted data independently to a predefined form. Disagreements were resolved through discussion and consensus. RESULTS: n-3 PUFA had no significant effect on the prevention of AF (OR 0.81, 95% CI 0.57 to 1.15; p=0.24). There was significant heterogeneity among the studies (p=0.002, I(2)=65.0%). Subgroup analysis showed no significant beneficial effect of fish oils in any subset of population. CONCLUSIONS: No significant effects of n-3 PUFA supplementation on AF prevention were observed in this meta-analysis. A large-scale trial with higher doses and longer follow-up might be required to rule out the possibility of any treatment benefit.