“It’s not a tremendous signal of risk,” said Piccini of the marine-oil on-treatment analysis. But it, along with consistent evidence from other studies, does give him pause. “If a patient came to me and said,
Doctor, I want to take omega-3 fish oil, because I want to reduce my risk of events, as an arrhythmia doctor I would say, ‘We don’t have great evidence to do that for preventing atrial fibrillation. And there’s actually some evidence that it could mildly increase your risk of developing it.’ ”
For those prescribed evidence-based marine-oil therapy for other indications, he said, “I think the take-home message certainly is, if they report palpitations or other signs or symptoms that could be due to atrial fibrillation, we should be aggressive about screening for atrial fibrillation,” and making the diagnosis as appropriate. If the incident AF resolves after stopping the treatment, “maybe it’s reasonable to refrain from prescribing the medication for that patient.”
VITAL-Rhythm and VITAL are supported by multiple grants from the National Institutes of Health. Albert discloses receiving grant support from St. Jude Medical, Abbott, and Roche. Schnabel reports receiving honoraria from Bristol-Myers Squibb/Pfizer. Piccini previously disclosed receiving research grants from Abbott, the Association for the Advancement of Medical Instrumentation, Bayer, Boston Scientific, and Philips and serving as a consultant to Abbott, Allergan, ARCA Biopharma, Biotronik, Boston Scientific, LivaNova, Medtronic, Milestone, Sanofi, Philips, and UptoDate.
A version of this article originally appeared on Medscape.com.