Beneficial Effects of Intravenously Administered N-3 Fatty Acids for the Prevention of Atrial Fibrillation after Coronary Artery Bypass Surgery: A Prospective Randomized Study

Heidt, Martin; Vician, Michael; Stracke, Sylvia; Stadlbauer, Thomas; Grebe, Mathias; Boening, Andreas; Vogt, P; Erdoğan, Aslan

doi:10.1055/s-0029-1185301

Cited by 112 publications

(118 citation statements)

References 20 publications

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“…4,5 However, almost all studies of AF, and other disease states, have tested the effects of EPA and DHA in combination. Although similar, DHA and EPA have a different length, shape, distribution, and metabolic fate.…”

Section: Clinical Perspective On P 983mentioning

confidence: 99%

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Ramadeen

Connelly

Leong‐Poi

et al. 2012

Circ: Arrhythmia and Electrophysiology

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Section: Clinical Perspective On P 983mentioning

confidence: 99%

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Ramadeen

Connelly

Leong‐Poi

et al. 2012

Circ: Arrhythmia and Electrophysiology

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“…For a randomized double-blind single-center study in Germany, 102 patients were recruited before a coronary bypass operation (Heidt et al, 2009). Throughout the hospital stay, they were given 1 ml/kg body weight/day of an intravenous formulation.…”

Section: New-onset Postoperative Afmentioning

confidence: 99%

Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both?

Schacky¹

2008

Current Opinion in Clinical Nutrition and Metabolic Care

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This review focuses on developments after 2008, when the topic was last reviewed by the author. Pertinent publications were found by medline searches and in the author's personal data base. Prevention of atrial fibrillation (AF) was investigated in a number of trials, sparked by one positive report on the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), considerations of upstream therapy, data from electrophysiologic laboratories and animal experiments. If EPA + DHA prevent postoperative AF, the effect is probably smaller than initially expected. The same is probably true for maintenance of sinus rhythm after cardioversion and for new-onset AF. Larger trials are currently ongoing. Prevention of ventricular arrhythmias was studied in carriers of an implanted cardioverterdefibrillator, with no clear results. This might have been due to a broad definition of the primary endpoint, including any ventricular arrhythmia and any action of the device. Epidemiologic studies support the contention that high levels of EPA + DHA prevent sudden cardiac death (SCD). However, since SCD is a rare occurrence, it is difficult to conduct an adequately powered trial. In patients with congestive heart failure, EPA + DHA reduced total mortality and rehospitalizations, but not SCD or presumed arrhythmic death. Of three trials in patients after a myocardial infarction, two were inadequately powered, and in one, the dose might have been too low. Taken together, while epidemiologic studies support an inverse relation between EPA + DHA and occurrence of SCD or arrhythmic death, demonstrating this effect in intervention trials remained elusive so far. A pro-arrhythmic effect of EPA + DHA has not been seen in intervention studies, and results of epidemiologic and animal studies also rather argue against such an effect. A different, and probably more productive, perspective is provided by a standardized analytical assessment of a person's status in EPA + DHA by use of the omega-3 index, EPA + DHA in red cell fatty acids. In populations with a high omega-3 index, SCD is rare. Intervention trials can become more effective by including a low omega-3 index into the inclusion criteria, thus creating a study population more likely to demonstrate an effect of EPA + DHA. This is especially relevant in case of rare endpoints, like new-onset AF or SCD.

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“…Механизмы антиаритмического и антиокислительного действия ПНЖК взаимосвязаны и включают модификацию системы эйкозаноидов, модификацию состава жирных кислот мембраных фосфолипидов, прямое воздействие неэстерифицированных жирных кислот на миокард, влияние на иннозитол-липидный цикл и сигнальные системы, а также ионные транспортные системы [7,11].…”

Section: Discussionunclassified

“…В проспективном рандомизированном исследовании M. C. Heidt с соавторами было показано, что периоперационное применение инфузии рыбьего жира в дозе 100 мг/кг/сут. сокращает частоту ПОФП после КШ и ведет к сокращению длительности пребывания в отделении интенсивной терапии и в стационаре [7].…”

Section: Discussionunclassified

Novel Approach to the Prevention of Postoperative Atrial Fibrillation

Boeva¹,

Kolesnikov²,

Ivanenko³

et al. 2015

СПНО (MPSE)

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; 2 ГБУЗ Ставропольского края «Ставропольская краевая клиническая больница», Ставрополь В открытое сравнительное исследование были включены 73 больных ИБС в возрасте 41 -75 лет (средний возраст 55±7,1 года; 82,2% мужчин) без клапанной патологии сердца и предшествующей мерцательной аритмии, госпитализированных с целью выполнения коронарного шунтирования в условиях искусственного кровообращения. Целью исследования явилось изучение влияния Омегавена на риск развития пароксизмов фибрилляции предсердий продолжительностью более 30 секунд и других осложнений в раннем послеоперационном периоде после хирургической реваскуляризации миокарда. Основную группу составили 33 пациента, которым выполняли внутривенные инфузии эмульсии Омегавена в дозе 100 мл в сутки однократно в первые 5-7 дней после оперативного вмешательства. Группу сравнения составили 40 пациентов, не получавших Омегавен. У пациентов основной группы достоверно реже возникали пароксизмы послеоперационной фибрилляции предсердий (9,1% против 32,5%, р<0,01) и другие жизнеугрожающие нарушения ритма и проводимости (25,0% против 6,1%, р<0,01), отмечено статистически значимое сокращение продолжительности послеоперационного периода (14,1 ± 2,21 против 22,9 ± 3,82 суток, р<0,05). Снижение относительного риска развития фибрилляции предсердий в данной группе составило 72%. В исследовании не было отмечено побочных эффектов, свойственных Омегавену. Полученные данные позволяют рекомендовать применение Омегавена с целью профилактики фибрилляции предсердий в раннем послеоперационном периоде хирургической реваскуляризации миокарда. Ключевые слова: коронарное шунтирование, послеоперационная фибрилляция предсердий, профилактика, омега-3 полиненасыщенные жирные кислоты, витамин Е, Омегавен. The effect of Omegaven (emulsion for total parenteral nutrition, containing ω-3 and ω-6 polyunsaturated fatty acids and vitamin E) intravenous infusion on the risk of atrial fibrillation paroxysms lasting for more than 30 seconds in the early postoperative period after coronary artery bypass grafting was studied in 73 patients with coronary artery disease aged 41-75 (mean age 55±7,1 years; 82,2% males) without valvular heart disease or history of atrial fibrillation. The main group consisted of 33 patients treated with intravenous infusion of Omegaven (100 ml per day, single dose) during the first 5-7 days after heart surgery. The comparison group consisted of 40 patients who did not receive Omegaven. The patients of the main group showed significantly lower rate of new-onset postoperative atrial fibrillation (9,1% vs. 32,5%, р<0,01), other life-threatening cardiac arrhythmias and conduction disorders (25,0% vs. 6,1%, р<0,01), and also considerable reduction of the postoperative period duration (14,1±2,21 vs. 22,9±3,82 days, р<0,05). The decrease in the relative risk of atrial fibrillation in the above group was 72%. The study detected no side effects of Omegaven. The data obtained suggest that Omegaven can be recommended for the prevention of atrial fibrillation in the early postoperative peri...

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Beneficial Effects of Intravenously Administered N-3 Fatty Acids for the Prevention of Atrial Fibrillation after Coronary Artery Bypass Surgery: A Prospective Randomized Study

Cited by 112 publications

References 20 publications

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both?

Novel Approach to the Prevention of Postoperative Atrial Fibrillation

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