Case report: : An 84-year-old man reported several episodes of palpitations over the previous 6 months. He had previously suffered a non-Q-wave myocardial infarction (MI) in 2005. He was referred to our clinic 2 years later when he was diagnosed with sick sinus dysfunction while receiving treatment with a beta blocker (bisoprolol), aspirin, and an angiotensin-converting enzyme (ACE) inhibitor (perindopril). To treat his condition we implanted the patient with an ALTRUA dual-chamber pacemaker (DDDR) (Boston Scientific, MN, USA). Analysis of the data in his pacemaker memory in December 2011 did not indicate any malfunctioning and verified approximately 8,000 premature ventricular beats (PVBs) daily and nonsustained ventricular tachycardia (NSVT). The patient agreed to add omega-3 fatty acid ethyl ester supplementation (1 g/day) to his regimen. Pacemaker analyses 3 months later indicated no NSVT and only 215 PVBs daily. The patient has remained well and has had no further ventricular arrhythmias. Omega-3 fatty acid ethyl ester supplementation may be beneficial in post-MI patients with pacemakers who develop ventricular arrhythmias.
Conclusions: There was a clear positive association between cessation of palpitations and commencement of treatment with Omacor by this patient, although any link must be considered speculative. The observed dramatic benefit sustained over 6 months of follow-up, in the absence of beta blocker or ACE inhibitor therapies, suggests a genuine effect of Omacor. Thus, non-invasive omega-3 fatty acid ethyl ester supplementation with Omacor may be of benefit in post-MI patients with ICDs who develop ventricular arrhythmias.