长期 ω-3 多不饱和脂肪酸补充对植入起搏器患者阵发性房性快速心律失常负担的影响：一项前瞻性随机研究的结果。
Effects of long-term ω-3 polyunsaturated fatty acid supplementation on paroxysmal atrial tachyarrhythmia burden in patients with implanted pacemakers: results from a prospective randomised study.
机构信息
Department of Cardiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
出版信息
Int J Cardiol. 2013 Oct 9;168(4):3812-7. doi: 10.1016/j.ijcard.2013.06.030. Epub 2013 Jul 26.
BACKGROUND
Sino-atrial node disease and aging increase AF risk. We investigated if long-term fish oil supplementation reduces paroxysmal atrial tachycardia/fibrillation (AT/AF) burden in patients aged ≥60 years with sinoatrial node disease and dual chamber pacemakers.
METHODS
Following a run-in period of 6 months (p1) where AT/AF burden was logged,78 patients were randomised to control or fish oil group (total omega-3 6 g/d) and AT/AF burden evaluated after 6 months (p2; 39 controls, 39 fish oil) and 12 months (p3; 39 controls; 18 fish oil). A subset of 21 fish oil patients crossed over to controls in the final 6 months (crossover group).
RESULTS
Median AT/AF burden increased significantly in controls (1.5%, 3.2%, 4.3%, P<.001) but not in fish oil patients at 6 months (1.4% to 2%, P=.46) or those continuing for 12 months (1.5%, 0.98%, 1%, P=.16). Time to first episode of AT/AF >1 min was not significantly different between the groups (P=.9). There was a rebound increase in AT/AF burden in p3 in cross over patients (2.2% to 5.8%, P=.01) reaching a level similar to controls (crossover vs. controls, 5.8% vs. 4.3%, P=.63) and higher than those who continued fish oil for 12 months (crossover vs. continued intake 5.8% vs. 1.2%, P=.02). Fish oil patients had shorter duration episodes of AT/AF with no difference in frequency compared to controls.
CONCLUSION
Long-term fish oil supplementation did not suppress AT/AF burden but may have attenuated its temporal progression related to aging and sinus node disease.
背景
窦房结疾病和衰老会增加房颤风险。我们研究了长期服用鱼油补充剂是否会降低患有窦房结疾病和双腔起搏器的≥60 岁患者阵发性房性心动过速/心房颤动（AT/AF）的负担。
方法
在为期 6 个月的导入期（p1）中记录 AT/AF 负担后，将 78 名患者随机分为对照组和鱼油组（总 ω-3 6 克/天），并在 6 个月（p2；39 名对照组，39 名鱼油组）和 12 个月（p3；39 名对照组；18 名鱼油组）评估 AT/AF 负担。在最后 6 个月，21 名鱼油患者中有一部分交叉到对照组（交叉组）。
结果
对照组 AT/AF 负担中位数显著增加（1.5%、3.2%、4.3%，P<.001），但鱼油组在 6 个月时无显著增加（从 1.4%增加到 2%，P=.46）或在继续治疗 12 个月时无显著增加（1.5%、0.98%、1%，P=.16）。两组间首次发生 AT/AF 时间>1 分钟的时间无显著差异（P=.9）。交叉组患者在 p3 时出现 AT/AF 负担的反弹增加（从 2.2%增加到 5.8%，P=.01），达到与对照组相似的水平（交叉与对照组，5.8%与 4.3%，P=.63），高于继续服用鱼油 12 个月的患者（交叉与继续摄入，5.8%与 1.2%，P=.02）。鱼油组的 AT/AF 发作持续时间较短，与对照组相比，发作频率无差异。
结论
长期服用鱼油补充剂不能抑制 AT/AF 负担，但可能减缓与衰老和窦房结疾病相关的时间进展。
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