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Fish Oil Supplementation and Risk of Ventricular Tachycardia and Ventricular Fibrillation in Patients With Implantable Defibrillators: A Randomized Controlled Trial
Abstract
CONTEXT: Clinical studies of omega-3 polyunsaturated fatty acids (PUFAs) have shown a reduction in sudden cardiac death, suggesting that omega-3 PUFAs may have antiarrhythmic effects. OBJECTIVE: To determine whether omega-3 PUFAs have beneficial antiarrhythmic effects in patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). DESIGN AND SETTING: Randomized, double-blind, placebo-controlled trial performed at 6 US medical centers with enrollment from February 1999 until January 2003. PATIENTS: Two hundred patients with an implantable cardioverter defibrillator (ICD) and a recent episode of sustained VT or VF. INTERVENTION: Patients were randomly assigned to receive fish oil, 1.8 g/d, 72% omega-3 PUFAs, or placebo and were followed up for a median of 718 days (range, 20-828 days). MAIN OUTCOME MEASURES: Time to first episode of ICD treatment for VT/VF, changes in red blood cell concentrations of omega-3 PUFAs, frequency of recurrent VT/VF events, and predetermined subgroup analyses. RESULTS: Patients randomized to receive fish oil had an increase in the mean percentage of omega-3 PUFAs in red blood cell membranes from 4.7% to 8.3% (P<.001), with no change observed in patients receiving placebo. At 6, 12, and 24 months, 46% (SE, 5%), 51% (5%), and 65% (5%) of patients randomized to receive fish oil had ICD therapy for VT/VF compared with 36% (5%), 41% (5%), and 59% (5%) for patients randomized to receive placebo (P = .19). In the subset of 133 patients whose qualifying arrhythmia was VT, 61% (SE, 6%), 66% (6%), and 79% (6%) of patients in the fish oil group had VT/VF at 6, 12, and 24 months compared with 37% (6%), 43% (6%), and 65% (6%) of patients in the control group (P = .007). Recurrent VT/VF events were more common in patients randomized to receive fish oil (P<.001). CONCLUSION: Among patients with a recent episode of sustained ventricular arrhythmia and an ICD, fish oil supplementation does not reduce the risk of VT/VF and may be proarrhythmic in some patients.
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“It was shown that among patients with a recent episode of sustained ventricular arrhythmia and an implantable cardiac defibrillator, fish oil supplementation might be proarrhythmic (137).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [137]
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Metadata
- Authors
- Raitt, M. H., Connor, W. E., Morris, C., Kron, J., Halperin, B., Chugh, S. S., McClelland, J., Cook, J., MacMurdy, K., Swenson, R., Connor, S. L., Gerhard, G., Kraemer, D. F., Oseran, D., Marchant, C., Calhoun, D., Shnider, R., & McAnulty, J.
- Affiliations
- Oregon Health & Science University (US)
- Providence St. Vincent Medical Center (US)
- Tufts University (US)
- Oregon State University (US)
- Corresponding author
- Raitt, Merritt H.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2005-06-15
- Volume
- 293
- Issue
- 23
- Pages
- 2884
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2099859189
- Cited by
- 371
- References
- 25
- Citations by year
- 2025: 3 · 2024: 7 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 9 · 2019: 3 · 2018: 9 · 2017: 11 · 2016: 11 · 2015: 6 · 2014: 14 · 2013: 19 · 2012: 36
- FWCI
- 40.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl061682-04)
- National Heart, Lung, and Blood Institute (R01HL61682)
- National Center for Research Resources (M01RR000334, 5M01 RR00334)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- omega-3 polyunsaturated fatty acids, ventricular tachycardia, ventricular fibrillation, implantable cardioverter-defibrillator, antiarrhythmic effect, red blood cell membrane fatty acids, recurrent arrhythmia, sudden cardiac death, arrhythmia recurrence, omega-3 deficiency
- MeSH terms
- Aged, Double-Blind Method, Erythrocyte Membrane, Female, Humans, Male, Middle Aged, Prospective Studies, Risk, Ventricular Fibrillation, Fatty Acids, Omega-3, Proportional Hazards Models, Survival Analysis, Defibrillators, Implantable, Tachycardia, Ventricular, Dietary Supplements
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