{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T09:06:05Z","timestamp":1768986365156,"version":"3.49.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,9,6]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>n-3 polyunsaturated fatty acids (n-3 PUFAs) exert antiarrhythmic effects and reduce sudden cardiac death. However, their role in the prevention of atrial fibrillation remains controversial. We aimed to determine the effect of n-3 PUFAs in addition to amiodarone and a renin-angiotensin-aldosterone system inhibitor on the maintenance of sinus rhythm after direct current cardioversion in patients with persistent atrial fibrillation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We conducted a randomized, double-blind, placebo-controlled, parallel-arm trial in patients with persistent atrial fibrillation, with at least 1 relapse after cardioversion, and treated with amiodarone and a renin-angiotensin-aldosterone system inhibitor. Participants were assigned to placebo or n-3 PUFAs 2 g\/d and then underwent direct current cardioversion 4 weeks later. The primary end point was the probability of maintenance of sinus rhythm at 1 year after cardioversion. Of 254 screened patients, 199 were found to be eligible and randomized. At the 1-year follow up, the probability of maintenance of sinus rhythm was significantly higher in the n-3 PUFAs\u2013treated patients compared with the placebo group (hazard ratio, 0.62 [95% confidence interval, 0.52 to 0.72] and 0.36 [95% confidence interval, 0.26 to 0.46], respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In patients with persistent atrial fibrillation on amiodarone and a renin-angiotensin-aldosterone system inhibitor, the addition of n-3 PUFAs 2 g\/d improves the probability of the maintenance of sinus rhythm after direct current cardioversion. Our data suggest that n-3 PUFAs may exert beneficial effects in the prevention of atrial fibrillation recurrence. Further studies are needed to confirm and expand our findings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01198275.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.111.022194","type":"journal-article","created":{"date-parts":[[2011,8,16]],"date-time":"2011-08-16T04:48:27Z","timestamp":1313470107000},"page":"1100-1106","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":77,"title":["n-3 Polyunsaturated Fatty Acids in the Prevention of Atrial Fibrillation Recurrences After Electrical Cardioversion"],"prefix":"10.1161","volume":"124","author":[{"given":"Savina","family":"Nodari","sequence":"first","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Triggiani","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Campia","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Manerba","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Milesi","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno M.","family":"Cesana","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai","family":"Gheorghiade","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL (U.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livio","family":"Dei Cas","sequence":"additional","affiliation":[{"name":"From the Department of Experimental and Applied Medicine-Section of Cardiovascular Diseases (S.N., M.T., A.M., G.M., L.D.C.) and Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies (G.M.C.), University of Brescia, Brescia, Italy, and Center for Cardiovascular Innovation (M.G.), Northwestern University Feinberg School of Medicine, Chicago, IL 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