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Fish Oil Supplementation and Arrhythmias
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To the Editor: Dr Raitt and colleagues1 conclude that "fish oil supplementation in patients with ICDs [implantable cardioverter-defibrillators] and recurrent ventricular arrhythmias should be avoided" and that its use "may be proarrhythmic in some patients." We think that the study findings must be placed into context. Although there was a shortened time to recurrent ventricular tachycardia (VT) with fish oil, there was no increase in mortality or incidence of ventricular fibrillation (VF) nor any effect on defibrillation threshold or the inducibility of VT/VF.
The observed increase in the incidence of VT with fish oil use may be limited to a select group of patients in whom the mechanism of VT/VF is secondary to a fixed arrhythmogenic substrate. In contrast, ischemically mediated VT/VF, by far the most common cause of sudden death in patients with coronary artery disease,2 appears to be sensitive to the antiarrhythmic properties of fish oil. This is . . . [Full Text of this Article]
Martin H. Strauss, MD
DrMarty@bellnet.ca
North York General Hospital
Toronto, Ontario
Paul Dorian, MD;
Subodh Verma, MD, PhD
Saint Michael’s Hospital
Toronto, Ontario
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