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Cardiovascular Research 2007 73(2):316-325; doi:10.1016/j.cardiores.2006.06.014
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Copyright © 2006, European Society of Cardiology

Pro- and antiarrhythmic properties of a diet rich in fish oil

Hester M. Den Ruijtera,*, Géza Bereckia,b, Tobias Opthofa, Arie O. Verkerka,b, Peter L. Zockc and Ruben Coronela

aExperimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
bDepartment of Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
cUnilever Food and Health Research Institute, Vlaardingen, The Netherlands

* Corresponding author. Tel.: +31 205663262; fax: +31 206975458. Email address: h.m.denruijter{at}amc.uva.nl

Increased consumption of fish rich in omega-3 polyunsaturated fatty acids ({omega}3-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 {omega}3-PUFAs in relation to various cardiac pathologies. Differences between circulating and incorporated {omega}3-PUFAs with respect to electrophysiology are emphasized.

We conclude that {omega}3-PUFAs alter cardiac electrophysiology and thereby may be pro- or antiarrhythmic, dependent on the mechanism of arrhythmia. As {omega}3-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 {omega}3-PUFA supplements or fatty fish should be tailored to individual patients with respect to the arrhythmogenic mechanisms associated with the underlying pathology.

KEYWORDS Arrhythmia (mechanism); Fish oil; Ion channels; Calcium (cellular); Fatty acids

Time for primary review 19 days


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