Food-Related Atrial Fibrillation? The Potential Role of Biogenic Amines in “Nutri-Arrhythmias” Genesis

Abstract

Atrial fibrillation (AF) is the most common type of arrhythmia: a disorganized electrical atrial activity leading to irregular ventricular beats. Its most common risk factors include high blood pressure, congenital and valvular heart diseases, aging, heart failure and coronary heart diseases. Other risk factors include excessive alcohol intake, tobacco smoking, diabetes mellitus and thyrotoxicosis. However, many cases are not associated with any of these risk factors: probably, in these patients, immunological, functional and even dietary mechanisms may be responsible to induce cardiac arrhythmias. Several studies have focused on immunological and neurohumoral mechanisms; however, little information is available about the potential relationship between dietary patterns and atrial fibrillation episodes. This case report describes a potential correlation between biogenic amines in ingested food and recurrent atrial fibrillation onset in a 61-years old man in absence of a remarkable clinical history and of the most common risk factors. The nutritional team instituted a food protocol: a low calories diet and eliminating biogenic amines-rich foods. During the follow-up (16 months), there was a noticeable weight loss and no arrhythmic episodes happened again. This clinical case provides evidence for a possible new relationship between some kinds of food and heart conduction (defining the very novel field of arrhythmogenic foods and of “nutri-arrhythmias”), recognizing biogenic amines-rich foods abuse as the potential trigger and substrate for atrial fibrillation. Therefore, we suggested that clinical history in patients with new onset AF should also include questions concerning the ingestion of histamine-rich foodstuffs (or other amines-rich food) and alcohol consumption: their effects may result to be synergistic in the alteration of cardiac rhythm and may explain the recurrence of an unexplained atrial fibrillation.

Omega-3 Polyunsaturated Fatty Acids: Benefits and Endpoints in Sport

“…N-3 PUFAs were demonstrated to make heart cells less excitable (by modulating ionic channels) and also to slower atrioventricular conduction and substantially lower the probability of having a prolonged QT interval [75]. Other indirect effects of long-chain n–3 fatty acids include lowering concentration (in both plasma and cell membranes) of the non-esterified fatty-acids, which have multiple pro-arrhythmic properties [76] and have recently been associated with an increased risk of sudden death among men enrolled in the Paris Prospective Study [77]. Their anti-inflammatory action could be the key to further cardiovascular beneficial effects.…”

Atrial fibrillation and autonomic nervous system: A translational approach to guide therapeutic goals

“…The most important mechanism is characterized by the activation of inflammatory pathways and stimulation of oxidative stress in which ANS imbalance could play an important role 40 . Several investigations have shown the relationship between the ingestion of histamine‐rich and other amines‐rich foods and risk of AF and other arrhythmias 41 . Histamine is a vasoactive amine, with an arrhythmogenic potential risk in cellular and animal models.…”

“…Finally, we cannot underestimate the important role of correct diet in AF patients, especially in those affected by ANS imbalance. It is important to not abuse of arrhythmogenic foods such as chocolate (especially if associated to salbutamol with the increased risk of methylxanthines triggering), cocoa‐rich foods and many other which contains biogenic amines 41 . Moreover a low‐carbohydrate diet, often used for weight loss, and strongly related to the increasing risk of AF should be avoided 40 .…”

Metabolite G-Protein Coupled Receptors in Cardio-Metabolic Diseases

“…Endogenous agonists for TAAR1 include common biogenic amines and include β-phenylethylamine (β-PEA), tyramine, octopamine, tryptamine, and thyronamine [ 416 ]. Tyramine is a trace amine naturally found in multiple dietary sources: aged cheeses, aged meat, alcoholic beverages, chocolate, some fruits, and vegetables [ 417 ]. Tyramine is produced by decarboxylation of dietary amino acids and metabolized by the intestinal microbiota [ 418 ].…”