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CLINICAL RESEARCH

Dietary Fish and n-3 Fatty Acid Intake and Cardiac Electrocardiographic Parameters in Humans

Dariush Mozaffarian, MD, DrPH, FACC^_*,,_*, Ronald J. Prineas, MD, PhD, Phyllis K. Stein, PhD and David S. Siscovick, MD, MPH^||

^_* Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School
Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, Massachusetts
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Heart Rate Variability Laboratory, Washington University School of Medicine, St. Louis, Missouri
^|| Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, Washington

Manuscript received January 12, 2006; revised manuscript received March 17, 2006, accepted March 22, 2006.

^_* Reprint requests and correspondence: Dr. Dariush Mozaffarian, 665 Huntington Avenue, Building 2, Room 315, Boston, Massachusetts 02115 (Email: dmozaffa{at}hsph.harvard.edu).

OBJECTIVES: We evaluated the association between dietary fish intake and several cardiac electrocardiographic parameters in humans relevant to arrhythmic risk.

BACKGROUND: Fish consumption may reduce the incidence of sudden death and atrial fibrillation, possibly related to anti-arrhythmic effects.

METHODS: In a population-based study of 5,096 men and women, we evaluated cross-sectional associations between usual dietary fish intake and electrocardiographic measures of heart rate, atrioventricular conduction (PR interval), ventricular repolarization (QT interval), and ventricular conduction (QRS interval). Multivariate models were adjusted for age, gender, race, education, smoking, body mass index, diabetes, coronary heart disease, physical activity, and intakes of beef or pork, fried fish, fruits, vegetables, alcohol, and total calories.

RESULTS: Consumption of tuna or other broiled or baked fish (comparing the highest to the lowest category of intake) was associated with lower heart rate (–3.2 beats/min, 95% confidence interval [CI] = 1.3 to 5.1; p trend <0.001), slower atrioventricular conduction (PR interval +7.2 ms, 95% CI = 1.4 to 12.9; p trend = 0.03), and substantially lower likelihood of prolonged QT (relative risk = 0.50, 95% CI = 0.27 to 0.95; p trend = 0.03). Tuna/other fish intake was not associated with ventricular conduction (p = 0.60). Findings were similar for estimated intake of marine n-3 fatty acids: a 1 g/day higher intake was associated with 2.3 beats/min lower heart rate (95% CI = 0.9 to 3.7), 7.6 ms longer PR interval (95% CI = 3.3 to 11.9), and 46% lower likelihood of prolonged QT (relative risk = 0.54, 95% CI = 0.33 to 0.88).

CONCLUSIONS: These findings in this large, population-based study suggest that dietary fish intake is associated with cardiac electrophysiology in humans, including heart rate, atrioventricular conduction, and ventricular repolarization, with potential implications for arrhythmic risk.

Abbreviations and Acronyms   CHD = coronary heart disease   CHS = Cardiovascular Health Study   CI = confidence interval   DHA = docosahexaenoic acid   ECG = electrocardiographic   EPA = eicosapentaenoic acid   HR = heart rate   QTc = corrected QT interval   QTI = QT index

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