Preoperative n-3 polyunsatured fatty acids are associated with a decrease in the incidence of early atrial fibrillation following cardiac surgery

Background: Atrial fibrillation (AF) after cardiac surgery is associated with increased mortality, morbidity, and expenditure. Controversial data exist on possible preventive effects of n-3 polyunsatured fatty acids (PUFAs) against postoperative AF. We investigated whether preoperative PUFA therapy is effective in reducing AF after cardiac surgery during the surgical hospitalization and/or the cardiac rehabilitation period. Methods: Over a 4-year period, 530 patients (363 men, 68.5%) with a mean age of 66.4 ± 10.9 years, undergoing cardiac surgery were monitored for "early AF" and "late AF" defined as AF documented in the surgical department or during the rehabilitation program, respectively. Results: The overall incidence of early AF in the whole study sample was 44.7%, whereas late AF occurred in 14.7% patients. Patients with AF had a longer length of hospital and rehabilitation stay (10.4 ± 9.8 vs 9.5 ± 9.2 days, P =.025 and 24.2 ± 15.3 vs 21.1 ± 8.3 days, P =.008, respectively). Early AF occurred in 31.0% of the patients with preoperative PUFAs compared with 47.3% of those without them (P =.006). Conversely, late AF was not influenced by preoperative PUFA regimen (11.9% vs 15.2%, P =.43). Preoperative PUFAs were independently associated with a 46% reduction in risk of early AF development (OR 0.54, 95% CI 0.31-0.92), after propensity score analysis. Conclusion: Preoperative PUFA therapy is associated with a decreased incidence of early AF after cardiac surgery but not late AF. Patients undergoing cardiac surgery may benefit from a preventive PUFA approach.