Marine n-3 polyunsaturated fatty acids (PUFA) may improve autonomic dysfunction,\nas indicated by an increase in heart rate variability (HRV) and reduce the risk of sudden cardiac\ndeath. Hence, the aim of this study was to investigate the effects of marine n-3 PUFA on 24-h HRV in\npatients on chronic dialysis, who have a high risk of sudden cardiac death. Between June 2014 and\nMarch 2016, 112 patients on chronic dialysis from Denmark were allocated to a daily supplement\nof 2 g marine n-3 PUFA or control for three months in a randomized, double-blinded, controlled\ntrial. A 48-h Holter monitoring was performed and mean 24-h HRV indices for the two days were\navailable in 85 patients. The mean age was 62.3 years (SD: 14.3) and median dialysis vintage was\n1.7 years (IQR: 0.5, 6.4). Within-group and between-group changes in outcome were evaluated by a\npaired and two sample t-test, respectively. Marine n-3 PUFA did not change the primary endpoint\nSDNN (SD of all RR-intervals) reflecting overall HRV, but other HRV indices increased and the mean\nRR-interval increased significantly, corresponding to a decrease in heart rate by 2.5 beats per minute\n(p = 0.04). In conclusion, marine n-3 PUFA did not change SDNN, but the mean heart rate was\nsignificantly reduced and changes in other HRV-indices were also observed, indicating an increase in\nvagal modulation that might be protective against malignant ventricular arrhythmias.
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