Effects of nutraceuticals on ventricular and atrial arrhythmias in patients with CRT

Introduction: It was recently demonstrate that an adequate intake of polyunsaturated fatty acids omega-3 (PUFA) reduces severe ventricular (V) and supra ventricular (SV) arrhythmia episodes and mortality in patients with history of myocardial infarction and heart failure by the reduction of fatal arrhythmias. Discrepant findings have been reported from several studies (Circulation. 2011; 124:1093-1096) due to different composition of the products used and the different clinical characteristics of patients analyzed. Objective: to investigate the effects of a combination of nutraceuticals (NUT) containing PUFA on the control of cardiac arrhythmias in patients with diagnosis of post-ischemic dilatative cardiomyopathy (CMPD), with implanted cardiac defibrillator (ICD ) Methods: This mono centric controlled study involved 10 male patients aged between 55 and 85 years with an implanted ICD, without chronic kidney disease more than grade 3 and free of prevalent cardiovascular events in the last 12 months All participants, after resetting the counter of arrhythmias in ICD, received placebo for 2 months, after which the device was controlled. Then they received the combination of PUFAs 2 times a day for 2 months, after which the ICD has been re controlled. An echocardiographic examination for the assessment of contractile function was performed at the beginning and end of the study for all the participants. Results: At the end of the study, for all patients it was recorded a significant reduction of total number of arrhythmias compared to the initial data. In particular there was a 46% reduction of BEV, 54.2% of the BEVS, 48% run of BESV, 33% of sustained and non-sustained TV episodes and FV (all p <0.0001), without any modification of the left ventricle function. Conclusion: In a group of patients with diagnosis of post-ischemic CMPD, with an implanted ICD, a combination of NUT reduces the number of supra ventricular and ventricular arrhythmias and could be a promising approach to reduce the risk of sudden death in patients with moderate to severe CV risk.