Impact of Preprocedural Serum Eicosapentaenoic Acid to Arachidonic Acid Ratio on Post-Ablation Recurrence of Atrial Fibrillation

Int Heart J. 2019 Nov 30;60(6):1334-1343. doi: 10.1536/ihj.19-329. Epub 2019 Nov 15.


The aim of this study was to examine the impact of the serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio on recurrence after catheter ablation (CA) for atrial fibrillation (AF).A total of 192 patients who underwent first-time radiofrequency CA for AF were enrolled in this study. They were divided into two groups based on the median serum EPA/AA ratio before CA: a LOW group (< 0.30; n = 96) and a HIGH group (≥ 0.30; n = 96). Patients in the LOW group were younger and had smaller left atrial diameter (LAD) than those in the HIGH group. Although pulmonary vein triggers initiating AF were more frequently observed in the LOW group than the HIGH group (63% versus 46%, respectively; P = 0.021), no significant between-group difference was observed regarding the incidence of AF recurrence since the last procedure (17% versus 17%, P = 0.78; median follow-up, 37 months). Multivariate Cox regression analysis after adjustment for age and LAD revealed that EPA/AA of < 0.30 was not a significant predictor of AF recurrence (hazard ratio, 1.12; 95% confidence interval 0.53-2.37; P = 0.76). However, in the non-paroxysmal AF subgroup (n = 65), the incidence of AF recurrence was significantly higher in the LOW group than in the HIGH group (25.7% versus 6.7%, respectively; P = 0.031).In conclusion, a lower preprocedural EPA/AA ratio, which was associated with younger age and small left atrium, was not a predictor for the risk of AF recurrence after CA for AF. The potential impact of the ratio on recurrence in non-paroxysmal AF subgroups should be examined with larger samples.

Keywords: Atrial tachyarrhythmia; Catheter ablation; Omega-3 polyunsaturated fatty acids.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Arachidonic Acid / blood*
  • Atrial Fibrillation / blood*
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / therapy*
  • Catheter Ablation*
  • Eicosapentaenoic Acid / blood*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome


  • Arachidonic Acid
  • Eicosapentaenoic Acid