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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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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