Fish vs olive oil for irregular heart

[Guest guest]

Hi All,

The below that is pdf-available as a paper seems to say that fish oil is better

than

olive oil for preventing irregular heartbeats.

Circulation. 2005;112:2762-2768.

Prevention of Fatal Arrhythmias in High-Risk Subjects by Fish Oil n-3 Fatty Acid

Intake.

Leaf, MD; Albert, M. MD, MPH; phson, Mark MD; Steinhaus,

MD; Kluger, MD; Kang, Jing X. MD, PhD; , BS; Zhang,

Hui

PhD; Schoenfeld, PhD; for the Fatty Acid Antiarrhythmia Trial

Investigators

Abstract

Background—: The long-chain n-3 fatty acids in fish have been demonstrated to

have

antiarrhythmic properties in experimental models and to prevent sudden cardiac

death

in a randomized trial of post–myocardial infarction patients. Therefore, we

hypothesized that these n-3 fatty acids might prevent potentially fatal

ventricular

arrhythmias in high-risk patients.

Methods and Results—: Four hundred two patients with implanted

cardioverter/defibrillators (ICDs) were randomly assigned to double-blind

treatment

with either a fish oil or an olive oil daily supplement for 12 months. The

primary

end point, time to first ICD event for ventricular tachycardia or fibrillation

(VT

or VF) confirmed by stored electrograms or death from any cause, was analyzed by

intention to treat. Secondary analyses were performed for “probable” ventricular

arrhythmias, “on-treatment” analyses for all subjects who had taken any of their

oil

supplements, and “on-treatment” analyses only of those subjects who were on

treatment for at least 11 months. Compliance with double-blind treatment was

similar

in the 2 groups; however, the noncompliance rate was high (35% of all

enrollees). In

the primary analysis, assignment to treatment with the fish oil supplement

showed a

trend toward a prolonged time to the first ICD event (VT or VF) or of death from

any

cause (risk reduction of 28%; P=0.057). When therapies for probable episodes of

VT

or VF were included, the risk reduction became significant at 31%; P=0.033. For

those who stayed on protocol for at least 11 months, the antiarrhythmic benefit

of

fish oil was improved for those with confirmed events (risk reduction of 38%;

P=0.034).

Conclusions—: Although significance was not achieved for the primary end point,

this

study provides evidence that for individuals at high risk of fatal ventricular

arrhythmias, regular daily ingestion of fish oil fatty acids may significantly

reduce potentially fatal ventricular arrhythmias.

.... All subjects were advised to use olive oil rather than the common plant seed

oils for cooking, dressings, and sauces. Subjects were asked to consume no more

than

2 fish meals per month. ...

.... There were 25 deaths during the study, with 13 in the group assigned to fish

oil

and 12 in those assigned to olive oil. Eighteen of the 25 deaths were classified

as

due to cardiac causes. These were divided equally between the fish oil and olive

oil

treatment arms. The cardiac deaths were largely due to progressive congestive

heart

failure but also included 4 attributed to arrhythmias (3 fish oil and 1 olive

oil).

For 10 of these patients, death was the only event. There were no serious events

in

either cohort attributable to the prescribed oil supplements. ...

.... TABLE 3. Analysis of Time to First Event

=============

Relative Risk 95% CL P

=============

Intention-to-treat analysis (N = 402)

Unadjusted

Confirmed events 0.72 0.51–1.01 0.057

Including probable events 0.69 0.49–0.97 0.033

Multivariate analysis*

Confirmed events 0.67 0.47–0.95 0.024

Including probable events 0.66 0.46–0.92 0.016

On-treatment analysis for all on treatment† (N = 402)

Controlling for baseline left ventricular ejection fraction

Confirmed events: 0.73 0.50–1.07 0.11

Including probable events 0.62 0.48–1.02 0.062

Multivariate analysis*

Confirmed events 0.67 0.46–0.98 0.037

Including probable events 0.65 0.45–0.95 0.026

On-treatment analysis for at least 11 mo (n = 236)

Confirmed events 0.62 0.39–0.97 0.034

Including probable events 0.62 0.40–0.96 0.029

Multivariate analysis*

Confirmed events 0.52 0.32–0.83 0.0060

Including probable events 0.53 0.34–0.84 0.0070

==================

*Multivariate model controlled for sex, left ventricular ejection fraction

(continuous), New York

Heart Association class III congestive heart failure, history of myocardial

infarction, history of prior

defibrillator therapies for VT/VF, time from ICD implant (continuous), and

sustained

ventricular

tachycardia as the indication for the ICD (all measured at baseline).

†On-treatment analysis for all subjects who had taken any of their prescribed

oil

supplements; the

follow-up was censored at 2 months after stopping medication.

On-treatment only of those subjects who were on treatment for at least 11

months.

....

Al Pater, PhD; email: old542000@...

__________________________________

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