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Effect of Supplemental Intake of Omega-3 Polyunsaturated Fatty Acids on the Rate and Complexity of Spontaneously Occurring Ventricular and Supraventricular Arrhythmias in Patients With Implantable Cardioverter Defibrillator (ICD) - A Randomized Clinical Trial

Phase 4
Conditions
Coronary Artery Disease
Arrhythmia
Registration Number
NCT00290056
Lead Sponsor
Sheba Medical Center
Brief Summary

We hypothesize that oral supplementation with omega-3 PUFA will decrease occurrence of arrhythmic events among post-MI, ICD recipients.

Detailed Description

This is a randomized, placebo-controlled, crossover, double- blind interventional study. Patients will receive 3.6 g of EPA and DHA fish oil and placebo oil for 6 months, randomly, in a crossover design, with a four month washout period between treatments.

Randomization will be stratified by ejection fraction (≤ 35% or \> 35%), and the type of the index arrhythmia (VT - spontaneous or inducible by electrophysiologic study (EPS), versus other - VF, SCD, Primary prevention - MADIT II).

Ischemia severity was chosen to be evaluated by Single Photon Emission Computed Tomography (SPECT) during stress (dipyridamol infusion).

Subcutaneous adipose-tissue biopsy, a biomarker considered the gold-standard for the objective assessment of long-term habitual dietary intake of fish and marine omega-3 PUFA (EPA and DHA) will be obtain.

Compliance will be monitored by counting returned capsules or bottles and by measuring the omega-3 PUFA composition in red blood cells (RBC).

Three different types of questionnaires will be used in this trial to obtain more information as to the additional potential benefit of omega-3 PUFA supplementation:

1. The newly Israeli Food Frequency Questionnaire (FFQ) will be used to examine dietary intake of other nutritional habits/patterns and its relationship to the study outcomes.

2. The Hebrew language SF-36 health survey will be used to examine general health status.

3. The Back questionnaires will be use to examine possible beneficial effects of fish oil supplementation on depressive symptomatology.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
105
Inclusion Criteria
  • post-MI patients.
  • Both single and Dual chamber ICD recipient.
  • implanted more than 3 months ago.
  • Agree to give written informed consent.
Exclusion Criteria
  • Less than 18 years of age.
  • ICD implantation as a 'bridge' to heart transplantation.
  • Stable antiarrhythmic medication over the last month prior to enrollment.
  • Patients taking class I antiarrhythmic medication.
  • A projected lifespan less than one year.
  • Participation in another trial (during or within 90 days before the study).
  • Use of supplemental n-3 fatty acids during the last 3 months.
  • Women who are pregnant and of childbearing potential who do not use adequate contraception.
  • Patients known to have a history of recent drug or alcohol abuse. 10) History or current intestinal or hepatic disease.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Primary Outcome Measures
NameTimeMethod
number of VT/VF episodescontinous
Secondary Outcome Measures
NameTimeMethod
All-cause mortality, cardiac mortality, recurrent and myocardial infarction.continous
Atrial arrhythmia and non-sustained ventricular arrhythmia (non-sustained VT or ventricular premature complex (PVC)) as documented by ICD memory or 24 hour ECG (Holter) recording.24 hours
Whether omega-3 PUFA supplementation exerts different effects according to ischemia severity assessed by stress perfusion nuclear imaging.time of the test

Trial Locations

Locations (2)

The Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Sheba Medical Center, Heart Institute, Electrophysiology Unit

🇮🇱

Tel-Hashomer, Israel

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