Omega-3 fatty acids and cardiac arrhythmias: Prior studies and recommendations for future research - A report from the national heart, lung, and blood institute and office of dietary supplements omega-3 fatty acids and their role in cardiac arrhythmogenesis workshop

Cardiac electric activity is strongly modulated by its environment. Factors modulating this activity include the metabolic state of the myocyte, the availability of oxygen and energy substrates (including plasma fatty acids and glucose), mechanical forces, autonomic tone, and the lipid composition of the cell membrane. Ion channels, exchangers, and pumps act as macromolecular complexes and are regulated by phosphorylation, prenylation, and numerous other signaling pathways. Contemporary changes in diet (including increased caloric content, increased consumption of glucose and omega-6 fatty acids, decreased consumption of omega-3 fatty acids) and an overall decrease in exercise and activity have contributed to an increased incidence of obesity and diabetes in the adult and pediatric population. These trends, in turn, have led to an increased incidence of cardiovascular diseases including atherosclerosis, AF, and congestive heart failure, each of which is associated with increased risk of mortality. SCD due to arrhythmias is a primary cause of increased mortality. Efforts to better understand the links between diet and cardiac rhythm have the potential to improve public health and welfare and to reduce the ballooning costs associated with treating cardiovascular disease. That omega-3 fatty acids have an impact on the fundamental elements (ion channels, exchangers, and modulators) of cardiac electric activity is now indisputable. However, the translation of this understanding into evidence-based public policy guidelines that can decrease the incidence of arrhythmias and SCD still requires significant additional efforts. In this review we have identified a number of concrete areas for investigation that will help to provide some of the information that is required to best meet this goal.