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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ed_uk on June 25, 2005, at 10:27:15
Fish Oil Supplementation and Risk of Ventricular Tachycardia and Ventricular Fibrillation in Patients With Implantable Defibrillators
A Randomized Controlled TrialMerritt H. Raitt, MD; William E. Connor, MD; Cynthia Morris, PhD, MPH; Jack Kron, MD; Blair Halperin, MD; Sumeet S. Chugh, MD; James McClelland, MD; James Cook, MD; Karen MacMurdy, MD; Robert Swenson, MD; Sonja L. Connor; Glenn Gerhard, MD; Dale F. Kraemer, PhD; Daniel Oseran, MD; Christy Marchant, RN, MBA; David Calhoun, RN; Reed Shnider, MD; John McAnulty, MD
JAMA. 2005;293:2884-2891.Context Clinical studies of omega-3 polyunsaturated fatty acids (PUFAs) have shown a reduction in sudden cardiac death, suggesting that omega-3 PUFAs may have antiarrhythmic effects.
Objective To determine whether omega-3 PUFAs have beneficial antiarrhythmic effects in patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF).
Design and Setting Randomized, double-blind, placebo-controlled trial performed at 6 US medical centers with enrollment from February 1999 until January 2003.
Patients Two hundred patients with an implantable cardioverter defibrillator (ICD) and a recent episode of sustained VT or VF.
Intervention Patients were randomly assigned to receive fish oil, 1.8 g/d, 72% omega-3 PUFAs, or placebo and were followed up for a median of 718 days (range, 20-828 days).
Main Outcome Measures Time to first episode of ICD treatment for VT/VF, changes in red blood cell concentrations of omega-3 PUFAs, frequency of recurrent VT/VF events, and predetermined subgroup analyses.
Results Patients randomized to receive fish oil had an increase in the mean percentage of omega-3 PUFAs in red blood cell membranes from 4.7% to 8.3% (P<.001), with no change observed in patients receiving placebo. At 6, 12, and 24 months, 46% (SE, 5%), 51% (5%), and 65% (5%) of patients randomized to receive fish oil had ICD therapy for VT/VF compared with 36% (5%), 41% (5%), and 59% (5%) for patients randomized to receive placebo (P = .19). In the subset of 133 patients whose qualifying arrhythmia was VT, 61% (SE, 6%), 66% (6%), and 79% (6%) of patients in the fish oil group had VT/VF at 6, 12, and 24 months compared with 37% (6%), 43% (6%), and 65% (6%) of patients in the control group (P = .007). Recurrent VT/VF events were more common in patients randomized to receive fish oil (P<.001).
Conclusion Among patients with a recent episode of sustained ventricular arrhythmia and an ICD, fish oil supplementation does not reduce the risk of VT/VF and may be proarrhythmic in some patients.
Posted by Phillipa on June 25, 2005, at 10:27:15
In reply to Fish oil issue, posted by ed_uk on June 24, 2005, at 9:00:14
Great! I'm taking fishoil now and I'm getting older. Cardiac disease runs in my family. Should I be taking it? Fondly PJ O
Posted by ed_uk on June 25, 2005, at 10:27:15
In reply to Re: Fish oil issue » ed_uk, posted by Phillipa on June 24, 2005, at 19:01:37
>Should I be taking it?
Yes, it's good for you (in general) :-)
~Ed xxx
Posted by Glydin on June 25, 2005, at 10:27:15
In reply to Fish oil issue, posted by ed_uk on June 24, 2005, at 9:00:14
The US just had a big recall of some Implantable Defibrillators due to V-tach and V-fib findings. I'm usure who the manufacturer was or alot of the details... but.... makes ya wonder....
Posted by Glydin on June 25, 2005, at 10:27:15
In reply to Re: Fish oil issue » ed_uk, posted by Glydin on June 24, 2005, at 20:24:27
I swear I remember there being rhythm issues directly linked to the device but this only addresses the lack of giving a proper shock - which does NOT, of course, correct the rhythm problem it's designed to..... it's like a chicken and egg puzzle...
From the US FDA:
FDA Issues Nationwide Notification of Recall of Certain Guidant Implantable Defibrillators and Cardiac Resynchronization Therapy Defibrillators
FDA is notifying health care providers and patients that the Guidant Corporation is recalling certain of its implantable defibrillators and cardiac resynchronization therapy defibrillators. These devices can develop an internal short circuit without warning, resulting in failure to deliver a shock when needed.The devices affected by this notification are:
PRIZM 2 DR, Model 1861, manufactured on or before April 16, 2002
CONTAK RENEWAL, Model H135, manufactured on or before August 26, 2004
CONTAK RENEWAL 2, Model H155, manufactured on or before August 26, 2004
The devices are surgically implanted in persons who have a type of heart disease that creates the risk of a life-threatening heart arrhythmia (abnormal rhythm). The devices deliver an electrical shock to the heart to restore normal heart rhythm. The PRIZM 2 and RENEWAL devices are subject to different failures, resulting in the devices' inability to deliver an electrical shock during episodes of arrhythmia -- which could lead to a serious, life-threatening event for a patient. There have been two deaths reported to FDA suspected to be associated with this malfunction."FDA's first priority is patient safety," said Daniel Schultz, MD, Director of FDA's Center for Devices and Radiological Health. "We want to ensure that all patients who may be affected by this problem are notified and seek appropriate medical advice from their physicians."
FDA is not making a recommendation on whether individual patients who have one of the Guidant devices should have it removed and replaced. This is a decision that should be made by a patient in consultation with his or her physician, based on the specific medical situation of the patient. Removal and replacement of the device may pose some risk, so it is important that patients and physicians carefully discuss this matter before making a decision.
FDA advises patients to take the following steps:
If you have not already been notified, contact your doctor to determine if you have an affected PRIZM 2, CONTAK RENEWAL, or CONTAK RENEWAL 2 device.
Continue to keep your regular doctor appointments.
If you feel an electrical shock from your device, immediately contact your doctor.
If there is an audible "beeping" from your CONTAK RENEWAL or RENEWAL 2 device, immediately contact your doctor or go to the nearest emergency room. Beeping may mean that your defibrillator is damaged.
Guidant also recently informed FDA that it is recalling another set of defibrillator devices called PRIZM AVT, VITALITY AVT, RENEWAL 3 AVT and RENEWAL 4 AVT. The company has said the devices are subject to a memory error, which may affect device performance. Currently, FDA is evaluating this information.If you are a physician or a patient who has experienced a problem with any of these defibrillators, please send a report to FDA's MedWatch program and to Guidant. See http://www.fda.gov/medwatch/ for filing information or call 1-800-FDA-1088 (1-800-332-1088).
Guidant will be posting information for physicians on its web site at www.guidant.com. If you have further questions, you may contact Guidant at 1-866-GUIDANT (1-866-484-3268).
####
Posted by ed_uk on June 25, 2005, at 10:27:15
In reply to Re: Fish oil issue » ed_uk, posted by Glydin on June 24, 2005, at 20:24:27
Hi Glydin!
>The US just had a big recall of some Implantable Defibrillators
That's a bit scary :-O
~Ed
Posted by Sarah T. on June 25, 2005, at 10:27:16
In reply to Fish oil issue, posted by ed_uk on June 24, 2005, at 9:00:14
Hi, Kara!
I just read ed's post, and I remembered that you had some palpitations a few months ago. I think you concluded they might have been caused by the bright light therapy and/or doxepin. I'm wondering whether the palpitations might have been due to several factors reinforcing each other, such as fish oil plus light therapy, etc.? Just a thought. I hope you're feeling better.
Posted by KaraS on June 25, 2005, at 10:27:16
In reply to KaraS, are you here??? » ed_uk, posted by Sarah T. on June 24, 2005, at 22:52:12
> Hi, Kara!
> I just read ed's post, and I remembered that you had some palpitations a few months ago. I think you concluded they might have been caused by the bright light therapy and/or doxepin. I'm wondering whether the palpitations might have been due to several factors reinforcing each other, such as fish oil plus light therapy, etc.? Just a thought. I hope you're feeling better.
Hi Sarah,Funny you should bring up that topic now as my palpitations have recently returned. They came back once I decreased my doxepin to 12.5 mg. I'm not currently taking any fish oil or using a lightbox either. I'm not having any panic attacks or anything, just that heart fluttering feeling once in a while. I babblemailed Ed and asked him some questions. I said that if I didn't know any better, I'd think that the doxepin was preventing the palpitations. He said that was entirely possible. I haven't had a chance to ask him more about that yet.
I'm not that worried about it though because the EKG I had a couple of months ago was normal and I haven't had any serious problems yet ... so I'm thinking that whatever it is, it's more of a nuisance than anything else.
Posted by tealady on June 26, 2005, at 22:35:38
In reply to Re: KaraS, are you here??? » Sarah T., posted by KaraS on June 25, 2005, at 0:11:30
> > Hi, Kara!
> > I just read ed's post, and I remembered that you had some palpitations a few months ago. I think you concluded they might have been caused by the bright light therapy and/or doxepin. I'm wondering whether the palpitations might have been due to several factors reinforcing each other, such as fish oil plus light therapy, etc.? Just a thought. I hope you're feeling better.
>
>
> Hi Sarah,
>
> Funny you should bring up that topic now as my palpitations have recently returned. They came back once I decreased my doxepin to 12.5 mg. I'm not currently taking any fish oil or using a lightbox either. I'm not having any panic attacks or anything, just that heart fluttering feeling once in a while. I babblemailed Ed and asked him some questions. I said that if I didn't know any better, I'd think that the doxepin was preventing the palpitations. He said that was entirely possible. I haven't had a chance to ask him more about that yet.
>
> I'm not that worried about it though because the EKG I had a couple of months ago was normal and I haven't had any serious problems yet ... so I'm thinking that whatever it is, it's more of a nuisance than anything else.
>Kara,
If it was me I'd be using calcium carbonate and sme magnesium at night ..at least 600mg calcium carbonate and 300 of magnesium...maybe carbonate..even oxide at a pinch.
Also ask your chemist if you can order in some magnesium carbonate light (its a real fine powder) ..mix say a half teaspoon in say half glass warm water. If you like add a little (like 1/8 teaspoon ascorbic acid and some citric acid ..ay 1/4 teaspoon) and stir vigorously...should fizz (like Berocca) and be clear or only slightly cloudy with no bitter taste if balance is correct.
Then add to bottled water..small amount to each bottle and sip thru the day.
This is a great way to get a bit of magnesium cheaply in your body..well absorbed too.Also use lite salt or eat bananas for potassium.
Together the magnesium and potassium may help prevent heartbeat irreguarities and calcium carbonate may help also.
Thing is it can't hurt.. If you do give it a go, let me know if it works for you. I'd really like to know:-)It does work for others. I know the calc/mag helps me if I ever get the heart racing stuff, and use the mag carbonate light /ascorbic acid too. No heart irregularities any more, but that doesn't prove it wasn't something else. (could be the Armour:-)
Just a suggestion,Jan
Posted by KaraS on June 27, 2005, at 20:39:23
In reply to Re: KaraS, are you here??? » KaraS, posted by tealady on June 26, 2005, at 22:35:38
> Kara,
> If it was me I'd be using calcium carbonate and sme magnesium at night ..at least 600mg calcium carbonate and 300 of magnesium...maybe carbonate..even oxide at a pinch.
> Also ask your chemist if you can order in some magnesium carbonate light (its a real fine powder) ..mix say a half teaspoon in say half glass warm water. If you like add a little (like 1/8 teaspoon ascorbic acid and some citric acid ..ay 1/4 teaspoon) and stir vigorously...should fizz (like Berocca) and be clear or only slightly cloudy with no bitter taste if balance is correct.
> Then add to bottled water..small amount to each bottle and sip thru the day.
> This is a great way to get a bit of magnesium cheaply in your body..well absorbed too.
>
> Also use lite salt or eat bananas for potassium.
> Together the magnesium and potassium may help prevent heartbeat irreguarities and calcium carbonate may help also.
> Thing is it can't hurt.. If you do give it a go, let me know if it works for you. I'd really like to know:-)
>
> It does work for others. I know the calc/mag helps me if I ever get the heart racing stuff, and use the mag carbonate light /ascorbic acid too. No heart irregularities any more, but that doesn't prove it wasn't something else. (could be the Armour:-)
> Just a suggestion,
>
> Jan
>
>
Hi Jan,I've been taking 500 mg. of calcium citrate (with a little carbonate in there too) and 500 mg. of magnesium. I've been taking them both at night though. Does it make a big difference if I take them throughout the day intstead?
I think my multi is low on Potassium so bananas or supplementation is a good idea.
Oddly enough, I haven't had any flutters in the last couple of days. Wierd. I don't know what's behind it.
Thanks,
Kara
Posted by tealady on June 27, 2005, at 22:11:03
In reply to Re: KaraS, are you here??? » tealady, posted by KaraS on June 27, 2005, at 20:39:23
> > Kara,
> > If it was me I'd be using calcium carbonate and sme magnesium at night ..at least 600mg calcium carbonate and 300 of magnesium...maybe carbonate..even oxide at a pinch.
> > Also ask your chemist if you can order in some magnesium carbonate light (its a real fine powder) ..mix say a half teaspoon in say half glass warm water. If you like add a little (like 1/8 teaspoon ascorbic acid and some citric acid ..ay 1/4 teaspoon) and stir vigorously...should fizz (like Berocca) and be clear or only slightly cloudy with no bitter taste if balance is correct.
> > Then add to bottled water..small amount to each bottle and sip thru the day.
> > This is a great way to get a bit of magnesium cheaply in your body..well absorbed too.
> >
> > Also use lite salt or eat bananas for potassium.
> > Together the magnesium and potassium may help prevent heartbeat irreguarities and calcium carbonate may help also.
> > Thing is it can't hurt.. If you do give it a go, let me know if it works for you. I'd really like to know:-)
> >
> > It does work for others. I know the calc/mag helps me if I ever get the heart racing stuff, and use the mag carbonate light /ascorbic acid too. No heart irregularities any more, but that doesn't prove it wasn't something else. (could be the Armour:-)
> > Just a suggestion,
> >
> > Jan
> >
> >
>
>
> Hi Jan,
>
> I've been taking 500 mg. of calcium citrate (with a little carbonate in there too) and 500 mg. of magnesium. I've been taking them both at night though. Does it make a big difference if I take them throughout the day intstead?
>
> I think my multi is low on Potassium so bananas or supplementation is a good idea.
>
> Oddly enough, I haven't had any flutters in the last couple of days. Wierd. I don't know what's behind it.
>
> Thanks,
> Kara
>
>Hi Kara,
Taking at night should probably be enough. The carbonate form is what was studied..but that was for racing (hyper) type heartbeats.
The mag. and potassium together just help some with arrythmias.
Potassium is a danger if high, so I definitely wouldn't supplement in it unless shown low on blood test and advised by doc etc.I thought when I wrote that post that bananas or lite salt occasionally may cover it. Does with me. Even brought up my blood levels.
If you do have blood electrolyte tests somewhere it would be best to check out your levels though.
If you take licorice (long term) that affects the potassium level too(lowers it), which can cause arrythmias etc in some..so this is when you ned the lite salt etc
Wasn't sure what you're on:-)
many drugs affect potassium levels as well :-)I've heard of someone who took magnesium during day gradually in the form I described and was able to prevent their arrymthias, so I thought I might mention it as it might be worth a try. The magnesium relaxes the muscle.
I used to have them before Armour..don't get any more :-) I suspect its the T3..initially on Armour , just 1/2 grain, they went far worse, I made an appointment to see the heart specialist , then all cleared up within 2 months. That's why I always recommend starting T3 very very gradually for everyone.
My aunt was on T4 only and she ended up needing a pacemaker afer age 60 ..she had those arrythmias since childhood as well. Her desription of them to me matched my own:-)
Jan
Posted by KaraS on July 2, 2005, at 15:33:23
In reply to Re: KaraS, are you here??? » KaraS, posted by tealady on June 27, 2005, at 22:11:03
> > > Kara,
> > > If it was me I'd be using calcium carbonate and sme magnesium at night ..at least 600mg calcium carbonate and 300 of magnesium...maybe carbonate..even oxide at a pinch.
> > > Also ask your chemist if you can order in some magnesium carbonate light (its a real fine powder) ..mix say a half teaspoon in say half glass warm water. If you like add a little (like 1/8 teaspoon ascorbic acid and some citric acid ..ay 1/4 teaspoon) and stir vigorously...should fizz (like Berocca) and be clear or only slightly cloudy with no bitter taste if balance is correct.
> > > Then add to bottled water..small amount to each bottle and sip thru the day.
> > > This is a great way to get a bit of magnesium cheaply in your body..well absorbed too.
> > >
> > > Also use lite salt or eat bananas for potassium.
> > > Together the magnesium and potassium may help prevent heartbeat irreguarities and calcium carbonate may help also.
> > > Thing is it can't hurt.. If you do give it a go, let me know if it works for you. I'd really like to know:-)
> > >
> > > It does work for others. I know the calc/mag helps me if I ever get the heart racing stuff, and use the mag carbonate light /ascorbic acid too. No heart irregularities any more, but that doesn't prove it wasn't something else. (could be the Armour:-)
> > > Just a suggestion,
> > >
> > > Jan
> > >
> > >
> >
> >
> > Hi Jan,
> >
> > I've been taking 500 mg. of calcium citrate (with a little carbonate in there too) and 500 mg. of magnesium. I've been taking them both at night though. Does it make a big difference if I take them throughout the day intstead?
> >
> > I think my multi is low on Potassium so bananas or supplementation is a good idea.
> >
> > Oddly enough, I haven't had any flutters in the last couple of days. Wierd. I don't know what's behind it.
> >
> > Thanks,
> > Kara
> >
> >
>
> Hi Kara,
> Taking at night should probably be enough. The carbonate form is what was studied..but that was for racing (hyper) type heartbeats.
> The mag. and potassium together just help some with arrythmias.
> Potassium is a danger if high, so I definitely wouldn't supplement in it unless shown low on blood test and advised by doc etc.
>
> I thought when I wrote that post that bananas or lite salt occasionally may cover it. Does with me. Even brought up my blood levels.
> If you do have blood electrolyte tests somewhere it would be best to check out your levels though.
>
> If you take licorice (long term) that affects the potassium level too(lowers it), which can cause arrythmias etc in some..so this is when you ned the lite salt etc
> Wasn't sure what you're on:-)
> many drugs affect potassium levels as well :-)
>
> I've heard of someone who took magnesium during day gradually in the form I described and was able to prevent their arrymthias, so I thought I might mention it as it might be worth a try. The magnesium relaxes the muscle.
> I used to have them before Armour..don't get any more :-) I suspect its the T3..initially on Armour , just 1/2 grain, they went far worse, I made an appointment to see the heart specialist , then all cleared up within 2 months. That's why I always recommend starting T3 very very gradually for everyone.
> My aunt was on T4 only and she ended up needing a pacemaker afer age 60 ..she had those arrythmias since childhood as well. Her desription of them to me matched my own:-)
> Jan
>
Hi Jan,I may try taking some more magnesium during the day. I've been wanting to up my dosage of that anyway.
I've been eating more bananas so that should take care of the potassium.
I'm not taking any licorice or other herbs right now, only 12.5 mg. of doxepin and only T4 for hypothyroid so there's nothing there that should create a problem. I wasn't experiencing the irregular beats at 25 mg. of doxepin so I don't think that 12.5 mg of it could be causing the trouble. So who knows?
I glad you're not having any problems with it any more.
Kara
This is the end of the thread.
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