~ Fish Oil May Help with Arrhythmias in Patients with Defibrillators

In a report published in the November 1 2005 issue of the American Heart Association journal Circulation, Alexander Leaf, MD of Massachusetts General Hospital and his Boston colleagues wrote that a daily omega-3 fatty acid supplement may help protect against potentially fatal ventricular arrhythmias.

In a double-blind randomized trial, 402 patients with implantable cardioverter/defibrillators received four capsules of a fish oil supplement containing a total of 2.6 grams eicosapentaenoic acid and docosahexaenoic acid, or four capsules containing 1 gram olive oil daily for one year. Intracardiac electrograms generated from defibrillator discharges due to episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) were used to determine confirmed arrhythmic events, while “probable” events were determined from data recorded by the defibrillator that supported a diagnosis of ventricular arrhythmia, but for which no electrogram was available due to the limited storage capacity of the device

After twelve months, twenty-eight percent of those who received fish oil compared to 39 percent of those who had received the olive oil capsules had experienced their first confirmed arrhythmic event or death from any cause. When probable events were included in the analysis, the risk reduction experienced by those in the fish oil group increased. In a separate adjusted analysis limited to participants who were compliant for at least 11 months, those who took fish oil had almost half the risk of experiencing an event at twelve months than that of the olive oil group.

The authors mention an article recently published in the Journal of the American Medical Association that concluded adverse effects associated with fish oils in patients with implanted defibrillators. They note that the participants’ red blood cell omega-3 fatty acids at the beginning of the JAMA study were already at levels that have been shown to be protective against arrhythmia and that the subjects were allowed to consume one meal of fatty fish per week, both of which may have rendered them less likely to experience benefits from supplemental fish oil. They also suggest that chance could account for the findings in view of the small size of the study population.

The current study adds to the evidence that omega-3 fatty acids have an anti-arrhythmic action and may reduce potentially life-threatening arrhythmias. “If the present data are confirmed,” the authors write, “these fatty acids may also be recommended as a less toxic alternative to usual antiarrhythmic drugs to prevent recurrent episodes of VT/VF.”

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