None of the secondary efficacy end points, including first recurrence of AF or flutter in the persistent group and both groups combined, reached statistical significance. Sixteen participants (5 percent) taking placebo, and 12 (4 percent) taking prescription omega-3 discontinued study medication due to an adverse event.
"In this population of patients with symptomatic paroxysmal AF or persistent AF, and no evidence of substantial structural heart disease, prescription omega-3 did not show evidence of reducing the recurrence of symptomatic atrial fibrillation," the authors write.
They add that several factors might contribute to the discordance between their findings and those of other studies. "Either the positive results reported in some trials represent a chance effect of small sample sizes or the differences are real. If the latter, there are several possibilities, including differences in the study populations, in population-specific AF mechanisms, in dosing regimens and product formulations, or in concomitant therapies. In our study, nearly half the events occurred during the first 2 weeks of follow-up, suggesting that fish oil may not have rapid effects, even with high-loading doses."
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