Arrhythmias & electrophysiology
Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals
Authors' conclusion
This meta-analysis suggests that high-dose EPA/DHA treatment is associated with an increased risk of AF in patients at high cardiovascular disease risk, whereas low-dose EPA/DHA does not appear to increase AF risk, even in high-risk populations. Further prospective studies are needed to evaluate any potential increased risk of higher doses balanced against potential benefits.
Study context
- Population
- Participants ≥50 years of age in randomized controlled trials of ≥500 mg/d of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) for ≥12 months, where possible without known atrial fibrillation (AF)/atrial flutter at baseline35 randomized controlled trials (37 data sets)
- Participants
- 114,592 participants
- Comparison
- omega-3 fatty acids (EPA/DHA) vs control, by omega-3 dose (above or below 1500 mg/d) and background cardiovascular disease risk status
- Outcome
- occurrence of new-onset AF
Methodological detailsincorporating both published and unpublished data
- Incorporating both published and unpublished data
Pooled result
As reported in the abstract
Occurrence of new-onset AF
Pooled odds ratio (OR) (95% CI)
High risk-high dose EPA/DHAstatistically significant increase in AF risk
1.43(1.14–1.79)
Absolute risk difference (CI)
High risk-high dose EPA/DHAincrease in AF risk
0.8%(0.40%–1.1%)
Odds ratio
- High risk-low dose · not statistically significant
- 1.07
- Low risk-low dose · not statistically significant
- 1.06
- Low risk-high dose · not statistically significant
- 1.03
Original publication
Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals. Circ Arrhythm Electrophysiol. Published 28 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it