Evidence supporting the use of: EPA (eicosapentaenoic acid)
For the health condition: Arrhythmia

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Eicosapentaenoic acid (EPA) is an omega-3 polyunsaturated fatty acid found primarily in fish oils. Its use to support or treat arrhythmias—abnormal heart rhythms—has a basis in scientific research, though the strength of the evidence is moderate and not unequivocal. Early observational studies and some randomized controlled trials suggested that EPA (often in combination with docosahexaenoic acid, DHA) may reduce the risk of sudden cardiac death, presumed to be due to antiarrhythmic effects. Proposed mechanisms include stabilization of cardiac cell membranes, modulation of ion channels, anti-inflammatory effects, and reduction of triglyceride levels, all of which may contribute to a reduced propensity for arrhythmias. However, more recent large-scale trials have produced mixed results. For instance, the REDUCE-IT trial demonstrated cardiovascular benefit with high-dose EPA, but this was primarily related to a reduction in major adverse cardiovascular events, and the specific effect on arrhythmia risk is still debated. Some studies also indicate a potential reduction in incidence of atrial fibrillation, while others have noted a possible increase in risk, especially with certain formulations or in specific populations. Overall, while there is scientific validation for the use of EPA in supporting cardiac health and a plausible rationale for antiarrhythmic effects, the clinical evidence for arrhythmia prevention or treatment specifically is moderate and sometimes conflicting. Further research is needed to clarify which patient populations might benefit the most.

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