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Journal of the American College of Cardiology

Clinical Articles, Lead Article

n-3 PUFA does not reduce recurrent AF

Pharmacological supplementation with 1 g of polyunsaturated fatty acid (n-3 PUFA) for one year does not reduce recurrent atrial fibrillation (AF) in patients with normal sinus rhythm, according to a study1 published recently in the Journal of the American College of Cardiology.

The double-blind, multicenter FORWARD trial involved 586 outpatients with confirmed paroxysmal AF that required cardioversion (n  = 428), at least two episodes of AF in the six months before randomisation (n  = 55), or both (103). Patients were randomly allocated to n-3 PUFA (1 g/day) or placebo for 12 months. The primary endpoint was symptomatic recurrence of AF.

There were no significant differences between patients allocated to placebo and those who received n-3 PUFA for the main outcome. At 12 months, 56 of 297 participants (18.9%) in the placebo group and 69 of 289 participants

(24.0%) in the n-3 PUFA group had a recurrent symptomatic AF (p = 0.17).

There was no difference between treatment with placebo and n-3 PUFA for any of the other pre-specified endpoints, including the composite of all-cause mortality, nonfatal stroke, nonfatal acute myocardial infarction, systemic embolism, heart failure development, or severe bleeding that occurred in 20

F004/0965(6.7%) and 16 (5.5%) of patients randomised to placebo or n-3 PUFA, respectively (p = 0.65).

The conclusion was that pharmacological supplementation with n-3 PUFA did not reduce recurrent AF in this study of symptomatic paroxysmal AF patients.


1. Macchia A, Grancelli H, Varini S, et al. Omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: results of the FORWARD (randomized trial to assess efficacy of PUFA for the maintenance of sinus rhythm in persistent atrial fibrillation) trial. J Am Coll Cardiol 2013;61.

Published on: January 25, 2013

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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