Afib Aspirin and Fish Oil

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Bob K. - 17 Apr 2007 19:44 GMT

I have a history of parox afib, maybe 10 episodes in 10 yrs. However, no
(known) episodes in last 4 years since I started flecainide.

I am on aspirin, now 325 mg/day per current cardiologist. I have asked
several cardiologists about aspirin dose and seems divided about 50/50 on
82 vs 325. Now my GP suggests I take fish oil supplements. I am aware of
possible issue with aspirin. I asked several cardiologists again (I have
access through a relative to a major university) and on this they
(predictably?) say don't know.

Only opinion from a doctor I ever saw on this was a responce from Dr. Weil
who said fish oil plus baby aspirin OK, but the answer was not in the
context of atrial fibrillation.

Dr. Chung, do you have an opinion on this? Thanks.

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anonymous@nowhere.you.know - 17 Apr 2007 20:10 GMT

> Afib Aspirin and Fish Oil
>
[quoted text clipped - 4 lines]
> sci.med.cardiology
> Followup to: newsgroup

ff>I have a history of parox afib, maybe 10 episodes in 10 yrs. However,
no

>(known) episodes in last 4 years since I started flecainide.
>
[quoted text clipped - 10 lines]
>
>Dr. Chung, do you have an opinion on this? Thanks.

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true@tomyword.com - 17 Apr 2007 20:27 GMT

>Now my GP suggests I take fish oil supplements. I am aware of
>possible issue with aspirin. I asked several cardiologists again (I have
[quoted text clipped - 4 lines]
>who said fish oil plus baby aspirin OK, but the answer was not in the
>context of atrial fibrillation.

A good review of the topic of fish oil is to be found here:

http://www.medscape.com/viewarticle/554507_print

It requires a one time free non-spam generating subscription. It is a
continuing medical education site for docs and other health folk.

Here is a small snip, the first part describes all the disorders they
review, but included is the one of most intrest to you and your
question. In short and plain english, a high likelihood to aid in
atrial fibrillation with limitations as discussed. Considering the
other well known benefits discussed anyone with heart concerns might
well consider it also, which is likely what your doc had in mind. The
omega3 oil discussed is what is found in fish oil, other sources
discussed in the article also:

"Potential cardioprotective mechanisms of action of omega-3 fatty acids
include antiarrhythmic, antithrombotic, antiatherosclerotic, and
anti-inflammatory properties as well as improving endothelial function
and lowering both blood pressure and serum triglyceride levels.

Arrhythmias. EPA and DHA may reduce the susceptibility of the myocardium
to fatal arrhythmias. Results from epidemiologic and randomized clinical
trials suggest that omega-3 fatty acids decrease the risk of sudden
cardiac death by reducing the myocardium's susceptibility to malignant
arrhythmias. Leaf et al[5] hypothesized that omega-3 fatty acids
stabilize the electrical activity of cardiac myocytes by inhibiting
L-type calcium channels, thereby preventing triggered arrhythmia after
potential discharges caused by excessive cytosolic calcium fluctuations.
This results in a prolongation of the

relative refractory period, reducing the risk of developing ventricular
fibrillation. Although most of the antiarrhythmic data has been
primarily from animal and cell culture studies, evidence does suggest
the acute antiarrhythmic effects of omega-3 fatty acids in human
beings,[6] although this study is limited by the lack of a placebo group
and small sample size."

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Bob K. - 18 Apr 2007 00:36 GMT

>>Now my GP suggests I take fish oil supplements. I am aware of
>>possible issue with aspirin. I asked several cardiologists again (I
[quoted text clipped - 42 lines]
> human beings,[6] although this study is limited by the lack of a
> placebo group and small sample size."

Thanks for your reply. I read the Medscape article, I was already a
member. If the question for me were fish oil or not on a stand alone
basis, it would be a no brainer, yes. But I am concerned with the blood
thinning effects since I take aspirin. so I guess the question still is,
for clot protection for someone with a history of Afib, what dosage
aspirin to go with the fish oil. In fact, as I asked , what dosage
aspirin alone. And to look ahead, it is possible one day I might have to
go back on coumadin. then what with the fish oil. The article has one
paragraph about this which I think says the fish oil effect on
coagulation are "little effect".

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Andrew B. Chung, MD/PhD - 18 Apr 2007 00:52 GMT

> I have a history of parox afib, maybe 10 episodes in 10 yrs. However, no
> (known) episodes in last 4 years since I started flecainide.
>
> I am on aspirin, now 325 mg/day per current cardiologist. I have asked
> several cardiologists about aspirin dose and seems divided about 50/50 on
> 82 vs 325.

You likely mean 81 vs 325.

> Now my GP suggests I take fish oil supplements. I am aware of
> possible issue with aspirin. I asked several cardiologists again (I have
[quoted text clipped - 6 lines]
>
> Dr. Chung, do you have an opinion on this?

My experience is that folks with coronary disease and atrial
fibrillation on both warfarin and aspirin have been able to take
omega-3 fatty acid supplements without an increase in rates of
bleeding complications when INR is monitored in the usual fashion.

> Thanks.

You are welcome.

Would redirect your thanks to GOD so that we will both be that much
more blessed.

Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
http://HeartMDPhD.com/Love/TheTruth

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Nel - 06 May 2007 03:05 GMT

Hi Bob,
I also have Afib. About one a year. Been lucky for a couple of years now
that I'm on Amiodarone. None of the other drugs worked for me.Always had to
have Cardioversions even being in the hospital 4 or 5 days, the meds. didn't
work.
My Cardio put me on Coumadin the last one I had and say not to take the
aspirin..When I was taking aspirin he had me on 82mgs..
Luck to you.....Nel

<achung@emorycardiology.com> wrote in message
news:1176853973.842048.292530@y5g2000hsa.googlegroups.com...

>> I have a history of parox afib, maybe 10 episodes in 10 yrs. However, no
>> (known) episodes in last 4 years since I started flecainide.
[quoted text clipped - 35 lines]
> Andrew B. Chung, MD/PhD
> http://HeartMDPhD.com/Love/TheTruth

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John.P.McDevitt@gmail.com - 07 May 2007 07:40 GMT

> Hi Bob,
> I also have Afib. About one a year. Been lucky for a couple of years now
[quoted text clipped - 48 lines]
> > Andrew B. Chung, MD/PhD
> >http://HeartMDPhD.com/Love/TheTruth

I am currently on Coumadin post-cardioversion and my GP wants me to
start taking Omacor (fish oil). She prescribed 1000mg but I have to
ask my cardiologist first. I assume it will be okay, but we will have
to be a little more careful about monitoring INR.

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