6 курс / Кардиология / И_А_Овсыщер_Реальна_ли_профилактика_ФП
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Omega-3 fatty acids (N-3 poly-unsaturated fatty acids - PUFAs) to Prevent AF
Omega-3 has shown beneficial effects to prevent AF such as:
Anti-inflammatory
Anti-oxidant
Anti-fibrotic effects.
Omega-3 fatty acids (N-3 poly-unsaturated fatty acids - PUFAs) to Prevent AF
Summary
The concept of preventing AF with Omega-3 is attractive and based on a large body of experimental data, the results of clinical studies are still equivocal.
Placebo-controlled trials of PUFAs are in progress.
Titles of 9 Registered PUFA Clinical Trials
FORomegaARD Trial
Arrhythmia prevention with an alpha-linolenic enriched diet
Use of fish oils to prevent mechanical stunning and atrial remodeling due to atrial arrhythmia randomized, single blind, placebo control
Use of fish oils to reduce the frequency and duration of episodes of AF in pts with PAF-randomized, single blind, placebo control
Evaluation of efficacy and safety of Omacor in recurrent, symptomatic AF
Omega-3 fatty acids for the prevention of AF after cardiac surgery - randomized, double-blind, placebo control
Omega 3 Fatty Acids and AF-randomized, double-blind, placebo
Fish oil for AF - effect and mechanisms - randomized, double-blind, placebo control
Randomized, prospective, placebo-controlled, multi-center study to test the efficacy of n - 3 PUFA for the maintenance of normal sinus rhythm in patients with persistent AF.
Non-anti-arrhythmic Drugs or
Upstream Therapy to Prevent AF
Summary
Effect of non-anti-arrhythmic drugs seem promising, over and above any effect related to the treatment of underlying disease.
However, despite exciting results from animal experiments and promising outcomes from several prospective and retrospective analyses, there is no robust evidence of specific effects of these drugs to transform current clinical practice.
Drug Therapy of AF
Conclusions - I
Pharmacologic therapy for conversion to and maintenance of SR in patients with AF traditionally has been limited by extracardiac side effects and proarrhythmic potential of existing antiarrhythmic drugs.
Currently there are new pharmacological agents that may shortly be released for the management of AF and many others that are currently under clinical investigation.
New anti-arrhythmic drugs targeting multiple channels or having a specific high affinity to the atrial myocardium are believed to have a more favorable risk/benefit ratio than traditional anti-arrhythmic drugs.
Drug Therapy of AF
Conclusions - II
New AF drugs and effective upstream antiinflammatory and anti-fibrotic therapy, may offer a much more comprehensive and effective antiarrhythmic strategy than is currently available.