Fish Oil and Post-Operative Atrial Fibrillation

Post-operative atrial fibrillation (PoAF) is among the most common complications of cardiac surgery and substantially increases morbidity and healthcare costs. Despite decades of surgical, anesthetic, and medical advances, rates of PoAF remain largely unchanged. Experiments and animal models suggest that perioperative fish oil (omega-3 fatty acids) may reduce PoAF (1). We recently reported in a large, multinational randomized trial that perioperative fish oil did not reduce PoAF (2). Yet several other trials have evaluated this question, with mixed results. Most of these trials were small, and some were open label (i.e., neither double blind nor placebo controlled).

To compile all peer-reviewed evidence and evaluate reasons for potential heterogeneity, we conducted a meta-analysis, following Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines, of randomized trials of fish oil for preventing PoAF. We searched MEDLINE from earliest available indexing through October 2012, without language restrictions.   Read more