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Effect of fish oil on ventricular tachyarrhythmia in three studies in patients with implantable cardioverter defibrillators Brouwer IA; Raitt MH; Dullemeijer C; Kraemer DF; Zock PL; Morris C; Katan MB; Connor WE; Camm JA; Schouten EG; McAnulty JEur Heart J 2009[Apr]; 30 (7): 820-6AIMS: To determine the effects of omega-3 polyunsaturated fatty acids (omega-3 PUFAs) from fish on the incidence of recurrent ventricular arrhythmia in implantable cardioverter defibrillator (ICD) patients by combining results from published trials. METHODS AND RESULTS: We searched in the Medline, EMBASE, and Cochrane databases and performed a meta-analysis on all three available trials on fish oil and ventricular arrhythmia. Furthermore, we pooled individual data of two of these randomized, double-blind, placebo-controlled trials (Raitt et al. Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial. JAMA 2005;293:2884-2891 and Brouwer et al. Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defibrillators: the Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) randomized trial. JAMA 2006;295:2613-2619). The main outcome was time to first confirmed ventricular fibrillation (VF) or ventricular tachycardia (VT) combined with death for the meta-analysis, and time to first spontaneous confirmed VF or VT for the pooled analysis. The meta-analysis (n = 1148) showed no convincing protective effect of fish oil (RR 0.90; 95% CI 0.67-1.22). The hazard ratio for the subgroup of patients with coronary artery disease at baseline (0.79; 0.60-1.06) tended towards a protective effect. The pooled analysis (n = 722) showed that time to appropriate ICD intervention was similar for fish oil and placebo treatment (log-rank P = 0.79). CONCLUSION: These findings do not support a protective effect of omega-3 PUFAs from fish oil on cardiac arrhythmia in all patients with an ICD. Current data neither prove nor disprove a beneficial or a detrimental effect for subgroups of patients with specific underlying pathologies.|*Defibrillators, Implantable[MESH]|Aged[MESH]|Dietary Supplements[MESH]|Fatty Acids, Omega-3/*therapeutic use[MESH]|Female[MESH]|Heart Failure/mortality/*prevention & control[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Prospective Studies[MESH]|Randomized Controlled Trials as Topic[MESH]|Secondary Prevention[MESH]|Tachycardia, Ventricular/mortality/*therapy[MESH]|Treatment Outcome[MESH] |
