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Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both?

Abstract

PURPOSE OF REVIEW

Recent publications seem to indicate no or an untoward effect of the marine omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid on cardiac rhythm. This review puts these developments into perspective.

RECENT FINDINGS

In-vitro or in animal models, little pro-arrhythmic effect, but many antiarrhythmic mechanisms of omega-3 fatty acids have been documented. In intervention studies in humans, eicosapentaenoic acid plus docosahexaenoic acid suppressed new atrial fibrillation in patients undergoing coronary bypass grafting. More importantly, in systematic reviews, it has been demonstrated that eicosapentaenoic acid plus docosahexaenoic acid reduce sudden cardiac death by 50%. In a recently published intervention study with eicosapentaenoic acid in patients at high cardiovascular risk in Japan, sudden cardiac death was rare. Sudden cardiac death is even rarer in the general population of Japan: it occurs 20 times less frequently than in the general population in Europe, e.g. Germany. In Japan, levels of eicosapentaenoic acid plus docosahexaenoic acid are high (omega-3 index estimated around 11%), whereas in Germany levels of eicosapentaenoic acid plus docosahexaenoic acid acids are low (omega-3 index around 4%). These and other data strengthen the concept that a low omega-3 index is a risk factor for sudden cardiac death, as a tool to assess the status of a person in terms of eicosapentaenoic acid plus docosahexaenoic acid, and as a means to monitor therapy with eicosapentaenoic acid plus docosahexaenoic acid.

SUMMARY

Concerns about pro-arrhythmic effects of eicosapentaenoic acid plus docosahexaenoic acid are largely theoretical. The evidence in favour of an antiarrhythmic effect is overwhelming, especially, when factoring in the omega-3 index.

Authors+Show Affiliations

Preventive Cardiology, University of Munich, and Omegametrix, Martinsried, Germany. Clemens.vonschacky@med.uni-muenchen.de

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18301082

Citation

von Schacky, Clemens. "Omega-3 Fatty Acids: Antiarrhythmic, Proarrhythmic or Both?" Current Opinion in Clinical Nutrition and Metabolic Care, vol. 11, no. 2, 2008, pp. 94-9.
von Schacky C. Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both? Curr Opin Clin Nutr Metab Care. 2008;11(2):94-9.
von Schacky, C. (2008). Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both? Current Opinion in Clinical Nutrition and Metabolic Care, 11(2), pp. 94-9. doi:10.1097/MCO.0b013e3282f44bdf.
von Schacky C. Omega-3 Fatty Acids: Antiarrhythmic, Proarrhythmic or Both. Curr Opin Clin Nutr Metab Care. 2008;11(2):94-9. PubMed PMID: 18301082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both? A1 - von Schacky,Clemens, PY - 2008/2/28/pubmed PY - 2008/5/28/medline PY - 2008/2/28/entrez SP - 94 EP - 9 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 11 IS - 2 N2 - PURPOSE OF REVIEW: Recent publications seem to indicate no or an untoward effect of the marine omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid on cardiac rhythm. This review puts these developments into perspective. RECENT FINDINGS: In-vitro or in animal models, little pro-arrhythmic effect, but many antiarrhythmic mechanisms of omega-3 fatty acids have been documented. In intervention studies in humans, eicosapentaenoic acid plus docosahexaenoic acid suppressed new atrial fibrillation in patients undergoing coronary bypass grafting. More importantly, in systematic reviews, it has been demonstrated that eicosapentaenoic acid plus docosahexaenoic acid reduce sudden cardiac death by 50%. In a recently published intervention study with eicosapentaenoic acid in patients at high cardiovascular risk in Japan, sudden cardiac death was rare. Sudden cardiac death is even rarer in the general population of Japan: it occurs 20 times less frequently than in the general population in Europe, e.g. Germany. In Japan, levels of eicosapentaenoic acid plus docosahexaenoic acid are high (omega-3 index estimated around 11%), whereas in Germany levels of eicosapentaenoic acid plus docosahexaenoic acid acids are low (omega-3 index around 4%). These and other data strengthen the concept that a low omega-3 index is a risk factor for sudden cardiac death, as a tool to assess the status of a person in terms of eicosapentaenoic acid plus docosahexaenoic acid, and as a means to monitor therapy with eicosapentaenoic acid plus docosahexaenoic acid. SUMMARY: Concerns about pro-arrhythmic effects of eicosapentaenoic acid plus docosahexaenoic acid are largely theoretical. The evidence in favour of an antiarrhythmic effect is overwhelming, especially, when factoring in the omega-3 index. SN - 1363-1950 UR - https://www.unboundmedicine.com/medline/citation/18301082/Omega_3_fatty_acids:_antiarrhythmic_proarrhythmic_or_both L2 - http://dx.doi.org/10.1097/MCO.0b013e3282f44bdf DB - PRIME DP - Unbound Medicine ER -