Effects of Chronic Omega-3 Polyunsaturated Fatty Acid Supplementation on Human Atrial Electrophysiology
Heart Rhythm, 2010, Dec 10; [Epub ahead of print]. Saurabh Kumar
Background
Omega-3 polyunsaturated fatty acids in fish oils may have anti-fibrillatory effects. Their mechanism of action in humans is poorly understood.
Objective
To investigate the effects of chronic fish oil supplementation on human atrial electrophysiology.
Methods
Two groups of patients without clinical AF or structural heart disease and fish intake ≤ 1/week were prospectively recruited into a control group (n=30) and a fish oil group (n=31). The latter were prescribed 6g/day of fish oil for a ≥1 month prior to an electrophysiology (EP) study. The following were compared at time of EP: serum omega-3 levels, right atrial and coronary sinus effective refractory periods (ERPs), inter-atrial, intra-atrial, left atrial and coronary sinus conduction at baseline and the maximal conduction delay with the shortest propagated extra-stimulus, and inducibility of AF (10 inductions/patient).
Results
The following significant differences were noted favoring the fish oil group at time of EP: (i) 2 fold higher total omega-3 levels (P<.001) (ii) lengthening of ERPs by 8-14% at all measured sites and pacing cycle lengths (P<.05) (iii) no effect on baseline inter-atrial, intra-atrial, left atrial and coronary sinus conduction but a significant attenuation of maximal conduction delay (P<.05) (iv) less inducible AF (AF ≥30 s: 24.2% vs. 7.9%, P<.001) (v) shorter mean duration of induced AF (P=.003) and (vi) prolongation of induced AF cycle length (P<.001).
Conclusions
Chronic fish oil supplementation in humans prolongs atrial refractoriness and reduces vulnerability to inducible AF. These electrophysiological changes may explain the anti-fibrillatory effect of chronic fish oil ingestion.