Low levels of cellular omega-3 increase the risk of ventricular fibrillation during the acute ischaemic phase of a myocardial infarction

Aarsetøy, Hildegunn; Pönitz, Volker; Nilsen, Odd Bjarte; Grundt, Heidi; Harris, William S.; Nilsen, Dennis W.T.

doi:10.1016/j.resuscitation.2008.04.007

Cited by 37 publications

(31 citation statements)

References 44 publications

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“…This is in keeping with the observation that a low omega-3 index increased the risk of ventricular fibrillation during the acute ischemic phase of a myocardial infarction (Aarsetoey et al, 2008), and the observation that a low omega-3 index was found to be associated with SCD (Aarsetoey et al, 2011). Of note, a 1% increase of the omega-3 www.frontiersin.org index was associated with a 58% (95% CI 0.25-0.76%) reduction in risk of VF during the acute phase of a myocardial infarction (Aarsetoey et al, 2011).…”

Section: Sudden Cardiac Deathsupporting

confidence: 89%

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

Schacky¹

2008

Current Opinion in Clinical Nutrition and Metabolic Care

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This review focuses on developments after 2008, when the topic was last reviewed by the author. Pertinent publications were found by medline searches and in the author's personal data base. Prevention of atrial fibrillation (AF) was investigated in a number of trials, sparked by one positive report on the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), considerations of upstream therapy, data from electrophysiologic laboratories and animal experiments. If EPA + DHA prevent postoperative AF, the effect is probably smaller than initially expected. The same is probably true for maintenance of sinus rhythm after cardioversion and for new-onset AF. Larger trials are currently ongoing. Prevention of ventricular arrhythmias was studied in carriers of an implanted cardioverterdefibrillator, with no clear results. This might have been due to a broad definition of the primary endpoint, including any ventricular arrhythmia and any action of the device. Epidemiologic studies support the contention that high levels of EPA + DHA prevent sudden cardiac death (SCD). However, since SCD is a rare occurrence, it is difficult to conduct an adequately powered trial. In patients with congestive heart failure, EPA + DHA reduced total mortality and rehospitalizations, but not SCD or presumed arrhythmic death. Of three trials in patients after a myocardial infarction, two were inadequately powered, and in one, the dose might have been too low. Taken together, while epidemiologic studies support an inverse relation between EPA + DHA and occurrence of SCD or arrhythmic death, demonstrating this effect in intervention trials remained elusive so far. A pro-arrhythmic effect of EPA + DHA has not been seen in intervention studies, and results of epidemiologic and animal studies also rather argue against such an effect. A different, and probably more productive, perspective is provided by a standardized analytical assessment of a person's status in EPA + DHA by use of the omega-3 index, EPA + DHA in red cell fatty acids. In populations with a high omega-3 index, SCD is rare. Intervention trials can become more effective by including a low omega-3 index into the inclusion criteria, thus creating a study population more likely to demonstrate an effect of EPA + DHA. This is especially relevant in case of rare endpoints, like new-onset AF or SCD.

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Section: Sudden Cardiac Deathsupporting

confidence: 89%

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

Schacky¹

2008

Current Opinion in Clinical Nutrition and Metabolic Care

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“…An epidemiologic study reported that the risk of SCD was lower in individuals with long-term fi sh consumption ( 31 ). This fi nding is consistent with studies reporting that a low omega-3 index increased the risk of ventricular fi brillation during acute ischemic phase of a MI and SCD ( 32,33 ).…”

Section: Downloaded Fromsupporting

confidence: 74%

Omega-3 fatty acid supplementation and cardiovascular disease

Jump

Depner

Tripathy

2012

Journal of Lipid Research

196

118

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“…n-3 PUFAs have been associated with decreased risk of ventricular arrhythmias (4,5) and sudden cardiac death (SCD) (6). Some authors have suggested that the beneficial impact on SCD could be mediated by enhancing the heart rate variability (HRV), which represents the sympathetic and parasympathetic activities of the autonomic nervous system (ANS).…”

Section: Introductionmentioning

confidence: 99%

Influence of n-3 fatty acids on cardiac autonomic activity among Nunavik Inuit adults

Valera¹,

Dewailly

Anassour-Laouan-Sidi³

et al. 2011

International Journal of Circumpolar Health

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Objectives. Inuit from Nunavik (northern Quebec) consume large amounts of fish and marine mammals, which are important sources of n-3 polyunsaturated fatty acids (n-3 PUFAs). These substances have a beneficial impact on heart rate (HR) and heart rate variability (HRV). However, it is unknown if this beneficial impact remains significant in populations with high mercury exposure. The study assessed the impact of n-3 PUFAs (Docosahexaenoic [DHA] and Eicosapentaenoic acid [EPA]) on resting HR and HRV among Nunavik Inuit adults considering mercury and other potential confounders. Study design. Cross-sectional study employing clinical measurements. Methods. Complete data were collected among 181 adults ≥40 years old (109 women and 72 men) living in the 14 coastal villages of Nunavik. Several indices of HRV were derived from a 2-hour Holter monitoring assessment. n-3 PUFAs levels were measured in membrane erythrocytes. Simple linear regression was used to analyse the relationship between n-3 PUFAs levels and resting HR and HRV parameters while multiple linear regressions were carried out to control for confounders. Results. In the overall analyses, EPA was associated with SDANN (β=0.07, p=0.04) and LF norm (β=-1.84, p=0.03) after adjusting for confounders. Among women, DHA was associated with resting HR (β=-1.40, p=0.03) while EPA was associated with SDNN (β=0.08, p=0.03), SDANN (β=0.09, p=0.02) and resting HR (β=-2.61, p=0.002). No significant association was observed in men. Conclusions. These results suggest a beneficial impact of n-3 PUFAs on resting HR and HRV among Nunavik Inuit women.

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Low levels of cellular omega-3 increase the risk of ventricular fibrillation during the acute ischaemic phase of a myocardial infarction

Cited by 37 publications

References 44 publications

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

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

Omega-3 fatty acid supplementation and cardiovascular disease

Influence of n-3 fatty acids on cardiac autonomic activity among Nunavik Inuit adults

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