Pro- and antiarrhythmic properties of a diet rich in fish oil.
Increased consumption of fish rich in omega-3 polyunsaturated fatty acids (omega3-PUFAs) is associated with decreased incidence of sudden cardiac death in post-myocardial infarction patients, but is also related to increased incidence of sudden death and arrhythmias in patients with acute myocardial ischemia. This review discusses the possible pro- and antiarrhythmic mechanisms of omega3-PUFAs in relation to various cardiac pathologies. Differences between circulating and incorporated omega3-PUFAs with respect to electrophysiology are emphasized. We conclude that omega3-PUFAs alter cardiac electrophysiology and thereby may be pro- or antiarrhythmic, dependent on the mechanism of arrhythmia. As omega3-PUFAs may be antiarrhythmic under conditions that favour triggered activity, they may facilitate re-entrant arrhythmias. This may explain the contradictory outcomes of increased intake of fish oil on sudden death and arrhythmias in clinical trials. Advice to increase intake of omega3-PUFA supplements or fatty fish should be tailored to individual patients with respect to the arrhythmogenic mechanisms associated with the underlying pathology.
Den Ruijter
Hester M
HM
Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. h.m.denruijter@amc.uva.nl
Berecki
Géza
G
Opthof
Tobias
T
Verkerk
Arie O
AO
Zock
Peter L
PL
Coronel
Ruben
R
D000200:Action Potentials / Q000502:physiology; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D004032:Diet; D019587:Dietary Supplements; D004562:Electrocardiography; D005395:Fish Oils; D006801:Humans; D007473:Ion Channels / Q000378:metabolism
D005395:Fish Oils; D007473:Ion Channels