Atrial Fibrillation
Conditions
Brief summary
To demonstrate that in patients with persistent atrial fibrillation who had recovered normal sinus rhythm and treated with the best recommended therapies, the addition of 1 gram / daily of n-3 PUFA is superior to the corresponding placebo for the maintenance of normal sinus rhythm at one year of follow up.
Detailed description
Atrial fibrillation (AF) impose a substantial and growing economic burden on health care expenditures. In patients with persistent AF, there are fundamentally two ways to manage the arrhythmia: to restore and maintain sinus rhythm (rhythm control) or to allow AF to continue and ensure that the ventricular rate is controlled (rate control). As it has been stated, it goes without saying that if we could prevent atrial fibrillation (AF) or restore and maintain sinus rhythm in patients suffering from persistent AF, without any penalties due to the unwanted effects of drugs or incomplete suppression of AF and its thromboembolic complications, every physician would do so. Current strategies however, are limited to achieve such desirable goal. In the last years a growing amount of evidence and attention regarding the cardio-protective role of Omega 3 fatty acids (n-3 PUFA) became progressively clear and appealing. Epidemiological studies and randomized controlled trials confirms the role of n-3 PUFA in reducing all cause mortality and cardiovascular events mostly in patients at high cardiovascular risk. These effects seems to be mediated mostly by an anti-arrhythmogenic effect. Basic science confirms and extended clinical observations regarding the antiarrhythmogenic effect of these compounds. Recently both basic research and clinical science suggested a role of n-3 PUFA for the prevention and treatment of supraventricular arrhythmias, particularly AF. The purpose of the study is to show that the addition of n-3 PUFA on the top of the best recommended therapies can improve the maintenance of normal sinus rhythm in patients with persistent atrial fibrillation.
Interventions
DIETARY_SUPPLEMENTOmega 3 (n-3 PUFA)
1 gram of n-3 PUFA containing DHA and EPA
DRUGPlacebo
Placebo
Sponsors
Fundacion GESICA
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Persistent atrial fibrillation
Exclusion criteria
* Contraindications or known hypersensitivity to n-3 PUFA * Current treatment with n-3 PUFA for any reason * Heart failure NYHA class IV * Coronary artery bypass surgery or valve replacement within the past 3 months * Planned cardiac procedures * Known sick-sinus syndrome * Diagnosis of Wolff-Parkinson-White * Clinical significant valvular etiologies * Presence of arrhythmia associated with an acute reversible condition * Advanced chronic lung disease * Contraindications for anticoagulation therapy * Pregnancy or lactation * Any non cardiac illness associated with a life expectancy of \< 2 years * Treatment with any investigational agent within 3 month before randomization * Any condition that in the opinion of the investigator would jeopardize the evaluation of efficacy or safety or be associated with poor adherence to the protocol
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Survival free of atrial fibrillation | 12 months |
Secondary
| Measure | Time frame |
|---|---|
| Number of patients in sinus rhythm at the time of each study visit | 12 months |
| Number of hospitalizations for CV reasons | 12 months |
| Number of all-cause hospitalizations | 12 months |
| Incidence of TE events | 12 months |
| Number of patients who die or with non-fatal thromboembolic events | 12 months |
Countries
Argentina
Outcome results
None listed