De ophef over het ontstaan van boezemfibrilleren ontstond in volle omvang toen in 2021 een meta-analyse van zeven RCTs (81.210 patiënten) liet zien dat visoliesuppletie na een mediaan van 4,9 jaar 25% meer boezemfibrilleren veroorzaakte. Dat ontstond vooral bij een visoliedosis boven 1 gram/dag: er was een duidelijke dosis-responsrelatie met boezemfibrilleren. De hoogste dosis omega-3-vetzuren uit visolie bedroeg in deze studies 4 g/dag.1 Als voorbeeld liet één van deze studies (REDUCE-IT) zien dat visolie een 25%-reductie van incidenten van hartvaatziekte veroorzaakte, maar dat daar tegenover stond een 50% verhoging van de opname in het ziekenhuis voor boezemfibrilleren. Een andere studie werd zelfs vroegtijdig gestopt vanwege meer risico op boezemfibrilleren.2 Er ontstond een discussie in de literatuur2-6b en eind 2023 haastten diverse instanties zich om te waarschuwen, waaronder het College ter Bevordering van Geneesmiddelen (CBG)7 en de Landelijke Registratie Evaluatie Bijwerkingen (LAREB)8. Het CBG gaf op 23 november 2023 een nieuwsbericht uit dat bestemd was voor zorgverleners en patiënten met de titel: ‘Verhoogd risico op onregelmatige en snelle hartslag bij gebruik omega-3-vetzuurethylestergeneesmiddelen bij hartpatiënten’.7
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