Both clinical and experimental evidence have suggested an anti-arrhythmic effect of long-chain n-3 polyunsaturated fatty acids (n-3-PUFAs) in fish oil.\u00a0 However, the effect of n-3-PUFAs on atrial arrhythmias such as postoperative atrial fibrillation (AF) remain uncertain.\u00a0 The Omega-3 Fatty Acids for Prevention of Post-operative Atrial Fibrillation (OPERA) trial was designed to test whether perioperative n-3-PUFA supplementation could reduce postoperative AF.<\/p>\n
\u00a01516 patients scheduled for cardiac surgery in 28 centres in the United States, Italy, and Argentina were enrolled between August 20120 and June 2012.\u00a0 Patients were randomised to receive fish oil or placebo, with preoperative loading of 10g over 3 to 5 days, followed postoperatively by 2g per day until hospital discharge or postoperative day first, whichever was sooner.\u00a0 Patients not in sinus rhythm at the outset were excluded.\u00a0 The main outcome measure was the occurrence of postoperative AF lasting longer than thirty seconds.<\/p>\n
\u00a0233 (30.7%) of patients assigned to placebo developed postoperative AF compared to 227 (30.0%) assigned to n-3 PUFAs (P=.74).\u00a0 The number of postoperative AF episodes also did not differ between the placebo and PUFA groups, nor did the incidence of AF that was sustained, symptomatic, or treated (P=.70).\u00a0 However, supplementation with n-3 PUFAs was generally well tolerated, and there was no suggestion of increased bleeding or serious adverse events.<\/p>\n
Conclusions:<\/strong><\/p>\n \u00a0This trial found no evidence that preoperative supplementation with n-3 PUFAs, compared with placebo, could reduce the risk of postoperative AF in patients undergoing cardiac surgery.<\/p>\n