Omega-3 polyunsaturated fatty acids in atrial fibrillation prevention after coronary bypass surgery
Abstract
Aim. To assess omega-3-polyunsaturated fatty acids (w-3-PUFA) effects on atrial arrhythmogenicity in patients with coronary heart disease, who underwent coronary bypass surgery (CBS).
Material and methods. In total, 50 patients, who underwent CBS, were examined. All participants were divided into two groups. Group I included 25 patients with atrial fibrillation (AF) episodes in anamnesis, who were administered w-3-PUFA (2 g/d) one week before and 7 days after CBS. Group II, control group, included 25 patients without AF in anamnesis, who did not receive w-3-PUFA. Atrial conduction abnormalities were registered by non-invasive, high-definition transesophageal electrocardiography.
Results. In Group II, 7 AF cases (28%) were registered during early post-CBS period. AF paroxysm incidence was maximal in the first two days after CBS. In Group I, AF paroxysms were registered in 4 patients (16%), on Day 2-3 after CBS. Clinical symptoms were less severe in Group I than in Group II: in the former, two patients had asymptomatic AF episodes. No AF cases required cardioversion, terminating spontaneously. Group I patients demonstrated increased right and left atrium conductivity.
Conclusion. In patients with post4CBS AF risk, w-3-PUFA therapy was associated with arrhythmia risk reduction, pontaneously terminating AF episodes, and less severe hemodynamic disturbances. Adding w-3-PUFA to standard therapy is effective and safe in CBS patients.
About the Author
B. A. TatarskyRussian Federation
References
1. Кушаковский М.С. Фибрилляция предсердий. (Причины, механизмы, клинические формы, лечение и профилакти4 ка). Санкт4Петербург 1999.
2. Мерцательная аритмия. Под редакцией С.А. Бойцова. Санкт-Петербург 2001.
3. Almassi G, Schowalter T, Nicolosi A, et al. Atrial fibrillation after cardiac surgery: a major morbid event. Ann Surg 1997; 226: 501-11.
4. Braunwald E. Heart Disease: A textbook of cardiovascular medicine (6th edition). Philadelphia 2001.
5. Eagle K, Guyton R, Davidoff R, et al. ACC/AHA guidelines for coronary artery bypass graft surgery. JACC 1999; 34: 1262-347.
6. Jayam V, Flaker G, Jones J. Atrial fibrillation after coronary bypass: etiology and pharmacologic prevention. J Cardiovasc Surg 2002; 10(4): 351-8.
7. Thompson A, Hirsch G, Pearson G. Assessment of new onset postcoronary artery bypass surgery atrial fibrillation: current practice pattern review and the development of treatment guidelines. J Clin Pharm Ther 2002; 27: 21-37.
8. Maisel W, Rawn J, Stevenson W. Atrial fibrillation after cardiac surgery. Ann Intern Med 2001; 135: 1061-73.
9. Mathew J, Parks R, Savino J, et al. Atrial fibrillation following coronary artery bypass surgery: predictors, outcomes and resource utilization. JAMA 1996; 276: 300-6.
10. Ommen S, Odell J, Stanton M. Atrial arrhythmias after cardio4 thoracic surgery. N Engl J Med 1997; 336: 1429-34.
11. American Heart Association. Heart Disease and Stroke Statistics – 2004 Update. Dallas, Tex: American Heart Association 2003.
12. GISSI-Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: the GISSI4Prevenzione trial. Lancet 1999; 354: 447-55.
13. Strauss M, Dorian P, Verma S. Fish Oil Supplementation and Arrhythmias. JAMA 2005; 294(17): 2165-6.
14. Siebert J, Rogowski J, Jagielak D, et al. Atrial fibrillation after coronary artery bypass grafting. Eur J Cardiothorac Surg 2002; 17: 520-3.
15. Zaman A, Archbold R, Paul E, et al. Atrial fibrillation after bypass surgery. A model for preoperative risk stratification. Circulation 2000; 101: 1403.
16. Kalman J, Munawar M, Howes L, et al. Atrial fibrillation after coronary artery bypass grafting is associated with sympathetic activation. Ann Thorac Surg 1995; 60: 1709-15.
17. Hogue C, Hyder M. Atrial fibrillation after cardiac operation: risks, mechanisms, and treatment. Ann Thorac Surg 2000; 69: 300-6.
18. Aranki S, Shaw D, Adams D, et al. Predictors of atrial fibrillation after coronary artery surgery: current trends and impact on hospital resources. Circulation 1996; 94: 390-7.
19. Asher C, Miller D, Grimm R. Analysis of risk factors handicap development of atrial fibrillation early after cardiac valvular surgery. Am J Cardiol 1998; 82: 892-5.
20. Haissaguerre M, Jais P, Shah D, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998; 339: 659-66.
21. Demaison L, Blet J, Sergiel JP, et al. Effect of dietary polyunsaturated fatty acids on contractile function of hearts isolated from sedentary and trained rats. Reprod Nutr Dev 2000; 40: 113-25.
22. Pepe S, McLennan PL. Cardiac membrane fatty acid composition modulates myocardial oxygen consumption and postischemic recovery of contractile function. Circulation 2002; 105: 2303-8.
Review
For citations:
Tatarsky B.A. Omega-3 polyunsaturated fatty acids in atrial fibrillation prevention after coronary bypass surgery. Cardiovascular Therapy and Prevention. 2007;6(2):52-58. (In Russ.)