Physician says negative arrhythmia-prevention studies apply only to high-risk cardiac casesby Craig Weatherby
Last week, we reported the results of a clinical trial that tested the effects of omega-3 fish oil supplements in heart patients with an implantable cardioverter defibrillator (ICD): a device designed to regularize the irregular heartbeats physicians call arrhythmias (See “New Study Fogs Positive Picture of Fish Oil and Arrhythmias”).
Together with those of a previous study in Oregon, the recently published results of the so-called European “SOFA” trial prompted us to write last week’s article. As with the Oregon results, the findings of the SOFA study indicate that supplemental fish oil produces little or no benefit in arrhythmia-prone patients with ICDs: that is, people at very high risk of sudden death from irregular heartbeats.
We pointed out that prior studies, involving populations not known to be at high risk, show clear reduction of the risk of sudden death from arrhythmias. Since we aren’t doctors, we were relieved to receive a letter from Adam B. Smith, M.D., which confirms the accuracy of our caveat.
Dr. Smith pointed out that both studies focused on people with a history and advanced risk of arrhythmia: populations least likely to benefit from a nutritional intervention. Here is his email, in red text:
I read your article on the SOFA trial, "New Study Fogs Positive Picture of Fish Oil and Arrhythmias", and would like to point out that the study population had, in all likelihood, cardiac electro-physiologic damage beyond the help of omega-3 supplements.
That is, many physiologic processes get to a point where they simply cannot be reversed or even attenuated, and it is likely that a study population requiring ICD's is simply beyond the help of omega-3s.
This in no way diminishes the power of earlier studies showing the undeniable benefit of omega-3s in preventing arrhythmia in less affected individuals.... I continue to recommend omega-3s in my practice with utmost confidence.
Adam B. Smith, M.D.
We thank Dr. Smith for taking the time to provide our readers with his informed professional opinion. It seems we were right to express skepticism about the general applicability of the negative studies on use of fish oil as an anti-arrhythmia drug in cardiac patients sick enough to need an implanted defibrillator.