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William Wallace: Does Fish Oil Increase Atrial Fibrillation Risk?
William Wallace/LinkedIn
Aug 24, 2026, 04:02

William Wallace: Does Fish Oil Increase Atrial Fibrillation Risk?

William Wallace, Co-Founder and Chief Scientific Officer at Supplement Success Solutions, shared a post on LinkedIn:

“Fish oil has carried an atrial fibrillation warning since 2021.

But across 35 randomized trials, the increased risk showed up in only one of four groups, and even there it amounted to about eight extra cases per 1,000 people.

Researchers pooled 35 trials involving 114,592 adults aged 50 and older, all followed for at least a year and none with atrial fibrillation at baseline. Participants were divided by two things: whether they took more or less than 1,500 mg per day of EPA and DHA, and whether they already had high cardiovascular risk.

There is a plausible reason those factors might matter. EPA and DHA become incorporated into cardiac cell membranes and can alter their electrical properties.

In an atrium that is already stretched, scarred, or electrically unstable, those changes may have more opportunity to trigger an arrhythmia.

Among people taking more than 1,500 mg per day of EPA and DHA who also had high cardiovascular risk, there were eight additional cases of atrial fibrillation per 1,000 people treated.

The confidence interval was roughly four to eleven additional cases. That is less than a 1% absolute increase, or about one additional case for every 125 people treated.

The other three groups did not show a significant increase.

So there appears to be a real signal, but it is much narrower than saying ‘fish oil causes atrial fibrillation.’ In this analysis, the risk was concentrated in higher-risk people taking higher doses.

An earlier meta-analysis of seven trials involving 81,210 people found increased atrial fibrillation more broadly, including at doses of 1 gram per day or less. Different dose cutoffs and statistical approaches make the two analyses difficult to compare directly.”

Title: Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals

Authors: Nada R Abuknesha, James H O’Keefe, Frank Qian, Nathan L Tintle, Yidie Lin, Yue Sun, Han-Zhu Qian, Paul S Aisen, Christine M Albert, William J Aronson, Abdul Aziz A Asbeutah, Heike A Bischoff-Ferrari, Matthew J Budoff, Nicholas R Burns, Cecilia A Cardenas, Cynthia M Carlsson, Emily Y Chew, Neal J Cohen, Léopold K Fezeu, Amana Liddell, Pilar Galan, Mark A Hull, Tsuo-Hung Lan, Pan-Yen Lin, Alexia Mengelberg, Anne-Marie Minihane, Joseph F Quinn, Thomas A B Sanders, Andrew Scholey, David A Schoenfeld, Kirsty Sprange, Kuan-Pin Su, Christopher H van Dyck, Carol A Van Hulle, David Vauzour, Claire Weber, Francine K Welty, Gary Wittert, William S Harris

William Wallace: Does Fish Oil Increase Atrial Fibrillation Risk?

Title: Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Authors: Baris Gencer, Luc Djousse, Omar T Al-Ramady, Nancy R Cook, JoAnn E Manson, Christine M Albert

William Wallace: Does Fish Oil Increase Atrial Fibrillation Risk?

Title: Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia

Authors: Deepak L. Bhatt, P. Gabriel Steg, Michael Miller, Eliot A. Brinton, Terry A. Jacobson, Steven B. Ketchum, Ralph T. Doyle, Jr., Rebecca A. Juliano, Lixia Jiao, Craig Granowitz, Jean-Claude Tardif, Christie M. Ballantyne

William Wallace: Does Fish Oil Increase Atrial Fibrillation Risk?

Title: Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial

Authors: Stephen J Nicholls, A Michael Lincoff, Michelle Garcia, Dianna Bash, Christie M Ballantyne, Philip J Barter, Michael H Davidson, John J P Kastelein, Wolfgang Koenig, Darren K McGuire, Dariush Mozaffarian, Paul M Ridker, Kausik K Ray, Brian G Katona, Anders Himmelmann, Larrye E Loss, Martin Rensfeldt, Torbjörn Lundström, Rahul Agrawal, Venu Menon, Kathy Wolski, Steven E Nissen

William Wallace: Does Fish Oil Increase Atrial Fibrillation Risk?

Other posts featuring William Wallace on Hemostasis Today.

A. Michael Lincoff Abdul Aziz A Asbeutah Alexia Mengelberg Amana Liddell Anders Himmelmann Andrew Scholey Anne-Marie Minihane Atrial Fibrillation Baris Gencer Brian G Katona Carol A Van Hulle Cecilia A Cardenas Christie M. Ballantyne Christine M Albert Christopher H van Dyck Claire Weber Craig Granowitz Cynthia M Carlsson Dariush Mozaffarian Darren K. McGuire David A Schoenfeld David Vauzour Deepak L Bhatt Dianna Bash Eliot A. Brinton Emily Y Chew Francine K Welty Frank Qian Gary Wittert Han-Zhu Qian Health Heike A Bischoff-Ferrari Hematology Hemostasis Hemostasis News Hemostasis Today James H O'Keefe Jean-Claude Tardif JoAnn E Manson John J. P. Kastelein Joseph F Quinn Jr. Kathy Wolski Kausik K. Ray Kirsty Sprange Kuan-Pin Su Larrye E Loss Léopold K Fezeu Lixia Jiao Luc Djoussé Mark A Hull Martin Rensfeldt Matthew J. Budoff Medicine Michael H. Davidson Michael Miller Michelle Garcia Nada R Abuknesha Nancy R. Cook Nathan L. Tintle Neal J Cohen Nicholas R Burns Omar T Al-Ramady P. Gabriel Steg Pan-Yen Lin Paul M Ridker Paul S Aisen Philip J Barter Pilar Galan Rahul Agrawal Ralph T. Doyle Rebecca A. Juliano Stephen J Nicholls Steven B. Ketchum Steven E. Nissen Terry A. Jacobson Thomas A B Sanders Torbjörn Lundström Tsuo-Hung Lan Venu Menon William J Aronson William S. Harris William Wallace Wolfgang Koenig Yidie Lin Yue Sun
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