The steady lup-dup, lub-dup regularity of our heart’s pumping beat is reassuring, and we don’t mind it speeding up for exercise or slowing down for sleep, as long as its rhythm remains steady. Any glitch in that rhythmic throb, whether too slow or too fast, is called an arrhythmia. In either case, you can feel dizzy or lightheaded because not enough blood is getting to the brain when the heart rhythm is off-kilter. To assess and correct an arrhythmia requires a medical professional. Many times it’s nothing serious–too much coffee or too little sleep. Sometimes the problem isn’t even heart-related: It could be a fever or an overactive thyroid. But sometimes the cause is indeed heart-related; for example, it could be the first sign of coronary artery disease.
Obviously, this WholeHealth Chicago Healing Center for Arrhythmias is no substitute for in-person diagnosis or professional treatment. But it can help you make certain lifestyle changes; and the herbs, and supplements we suggest can definitely reduce your susceptibility to heartbeat irregularity and the anxiety that often accompanies it.
What is Arrhythmia?
Arrhythmias are abnormal heart rhythms caused by a malfunction in part of the heart’s electrical system. While it’s not dangerous for the heart to skip a beat occasionally, some arrhythmias are serious and can even be fatal.
The sudden speeding up of your heart in response to too much coffee or an alarm suddenly going off is a response to a release of adrenaline, your “fight-or-flight” hormone. This is a perfectly normal physiologic response by your body and is not a sign of any heart disease. Likewise, well-trained athletes often have very slow heart rates because their heart-as-a-pump is working with an enviable degree of efficiency. It’s when your heart seems to be racing without any discernable reason, or beating slowly and you’re feeling lightheaded, that something is amiss and you need medical help.
An arrhythmia can be totally regular, just like a normal heart beat, where, in rapid succession first the upper chambers first contract, and then the lower ones. Or, an arrhythmia can be completely irregular with no discernible pattern.
Normally, heart rhythm originates in a specialized part of the upper chamber called the sinus node. An abnormal rhythm can begin there, or in the other parts of the heart as well. If the arrhythmia originates somewhere in the upper chambers (called the atria), it is termed an atrial arrhythmia. Those originating in the lower chambers (called the ventricles) are termed ventricular arrhythmias and clinically are much more dangerous.
Doctors generally divide arrhythmias into two main groups: tachycardias (in which the heart beats faster than 100 times a minute) and bradycardias (fewer than 60 beats per minute).
There are a number of different types of tachycardia.
With sinus tachycardia, for instance, the heartbeat starts in the right place, but the heart simply beats too fast. This situation frequently occurs in conditions unrelated to the heart itself, such as when you’ve drunk too much coffee, are watching the final twenty minutes of “The Silence of the Lambs” for the first time, or you have an overactive thyroid.
Supraventricular tachycardias are fast (120-200 beats per minute) and regular. These start anywhere in the atria in the upper chambers and rapidly travel to the ventricles (lower chambers), initiating a contraction. When the initiating point of the arrhythmia is located in one of the ventricles instead of anywhere in the atria, this is the dangerous ventricular tachycardia. The reason these are so dangerous is because although the heart is beating wildly, it’s hardly pumping any blood.
In yet another type of arrhythmia, termed atrial flutter, the atria is beating wildly but not every beat is being transmitted, and the ventricles contract normally, just too rapidly.
Last among the tachyarrhythmias is atrial fibrillation, a quite common arrhythmia that affects millions of people. In this situation, there is totally uncoordinated and very rapid (300-500 beats per minute) atrial action, but only a small portion of the electrical impulses make it through to the ventricles. The key feature of atrial fibrillation is the total irregularity of the heart beat. The main danger of atrial fibrillation is stagnation of the blood within the inefficiently contracting atria. If blood is not cleared from the heart, it can clot. In time, a piece of the clot can break free, travel into the bloodstream, and trigger a stroke. Fortunately, prescription medications coupled with lifestyle measures and the use of certain supplements can help keep the family of tachyarrhythmias under control.
Bradycardia, on the other hand, is characterized by slowness.
Although well-trained athletes can have a slow (and extremely efficient) heart pumping action, older people can develop a problem in the electrical system termed heart block. In these cases, the heartbeat is slow and irregular.
What is Arrhythmia?
Usually classified with the bradycardias is a condition known as sick sinus syndrome. Here the heart alternates between periods of beating too fast (tachycardia) and then too slow (bradycardia).
Whether due to heart block or the sick sinus syndrome, bradycardias that cause such symptoms as lightheadedness or even loss of consciousness, are generally treated by the insertion of a pacemaker rather than any medication.
Heart palpitations–a heartbeat that feels irregular (pounding, fluttering)
Shortness of breath and fatigue
Arrhythmias sometimes have no symptoms at all and may be discovered during a routine medical exam
What Causes Arrhythmia?
By far the most common cause of arrhythmia (that’s not a normal physiologic response to something like a police siren) is coronary artery disease (CAD), in which the blood supply to the heart is reduced because cholesterol plaque builds up and then gradually or suddenly narrows the blood vessels. As the heart tissue is gradually damaged due to loss of its blood supply, it becomes especially susceptible to developing an arrhythmia.
Heart damage can also be the result of a myocardial infarction, better known as a heart attack. In this case, the blood supply is actually cut off when a blood vessel becomes blocked, not simply narrowed. This causes a significant area of damage to the heart and again the affected tissue is especially susceptible to developing arrhythmia.
Other heart-related causes of arrhythmia include congestive heart failure and congenital heart defects, where a person is born with an anatomical abnormality.
In normal circumstances, both stress and heavy physical exertion can (correctly) increase the heart rate. This is a normal response so that an increased amount of blood is directed to the muscles. However, a variety of other situations unrelated to the heart itself can also trigger an arrhythmia, almost always one of the “tachys,” i.e., an overly rapid heart rate. These can include:
Certain stimulants–nicotine; caffeine; asthma medications, such as albuterol and ephedrine; decongestants; and appetite suppressants, which often contain plant-based forms of ephedrine, such as the Chinese herb ma huang.
Excess of thyroid hormone, either as hyperthyroidism (Grave’s Disease) or simply taking too much thyroid medication.
Certain medications, like the tricyclic antidepressants or the heart medicine digoxin, which can cause serious arrhythmias in high doses.
Electrolyte imbalance (especially potassium and magnesium). Such imbalances can occur when using diuretics or in a patient with kidney disease.
Use of marijuana or cocaine
High blood pressure
Certain lung conditions, such emphysema
Chest injury or surgery. And, with some arrhythmias–especially short-lived ones–the cause may never be found.
Treatment and Prevention
There are many different medications used for arrhythmias, and they act on the heart in a variety of ways. Some slow the electrical impulse of the arrhythmia as it travels through the heart (digoxin, calcium channel blockers like verapamil). Others literally sedate the irritable focus on the heart that’s initiating the arrhythmia (procainamide, quinidine). The most widely used group of anti-arrhythmics are the beta blockers (like propranolol or atenolol), which block the effect of the stress hormone adrenaline (epinephrine) from speeding up the heart rate.
The tachyarrhythmia family of abnormal heart beats are most commonly treated by carefully avoiding known precipitating factors, such as caffeine, tobacco, or decongestant (ephedrine-containing) drugs. For patients with atrial fibrillation, anticoagulant drugs (warfarin, aspirin) are added to prevent the formation of a potentially fatal blood clot in the stagnant blood inside the heart itself.
The bradyarrhythmia family, when causing symptoms, is treated by insertion of a pacemaker. This small device, surgically implanted beneath the skin, connects wires to key parts of the heart muscle. Its role is to supply an electrical impulse to the heart to maintain the beat at a regular rate.
Lifestyle practices and supplements can serve as useful adjuncts to standard medical treatments. But they should not be used in lieu of drugs or surgery. And it is extremely important to never even consider discontinuing any heart medicine on your own. If you’re planning to use any supplements or herbs for heart health, it’s a good idea to review them with your physician before you begin a new regimen.
How Supplements Can Help
Magnesium supplements can aid arrhythmia sufferers, many of whom are deficient in this mineral. Magnesium, in conjunction with calcium and potassium, coordinates the activity of specialized heart cells that regulate heart rhythm. The trace mineral manganese also promotes healthy cardiac nerve function.
Coenzyme Q10 is a natural substance found in all the cells of the body helps fuel cellular activity. It is also an antioxidant, and can neutralize cell-damaging oxygen molecules called free radicals. Coenzyme Q10 is very much involved with heart function and can be useful both to stabilize heart rhythm and to control congestive heart failure. This supplement appears to be particularly beneficial for people who already have had a heart attack or who have other forms of heart disease.
The herb hawthorn (or “crataegus”) is widely used in Europe for virtually all forms of heart disease. It appears to work by increasing blood flow to the heart, improving the strength of its contractions and regulating its rhythm.
Fish oils, which contain the essential omega-3 fatty acids, appear to be able to both prevent and relieve certain disturbances in heart rhythm. Regular eating of oily types of ocean fish has been shown in several studies to reduce the odds of developing a fatal cardiac arrhythmia.
The amino acid taurine and the amino acid-like substance carnitine increase oxygen supply to the heart.
Astragalus has been found to contain various substance that stabilize heart rhythm.
If you smoke, stop. Cigarettes are well-known contributors to heart disease and can trigger heart rhythm abnormalities. Smoking is the leading preventable cause of death among men and women in the Unites States.
Cut out or cut down on alcohol and caffeine. These heart stimulants can all trigger arrhythmias.
Eat fish (particularly salmon, trout, mackerel, and tuna) twice a week or more. These fish are rich in heart-healthy omega-3 fatty acids.
Exercise. Regular aerobic exercise, such as walking, biking, or jogging, can strengthen the heart.
Reduce stress. Avoid stressful situations when possible. For example, if you get frustrated when driving in traffic, leave earlier or later to avoid the rush. Incorporate activities that promote relaxation into your daily life. Meditation, yoga, and tai chi are proven methods for lowering stress.
When to Call a Doctor
If you notice palpitations for the first time. Palpitations are any uncomfortable awareness of your heartbeat. They can range from a flip-flop sensation, or a thumping or pounding to a peculiar fluttering sensation. All persistent or recurrent palpitations require diagnostic investigation.
If you experience severe chest pain or shortness of breath
If you become light-headed, dizzy, confused, or feel excessively weak or faint
If you are taking any medication for arrhythmia and you notice a new pattern to your heartbeat. Some medicines, such as digoxin, actually produce their own unique arrhythmias when taken in excess. In addition, over-the-counter medications and dietary supplements may influence the effectiveness of your medication. Any additions, subtractions, or changes in doses of these products should be discussed with your doctor.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700, ext. 2001.
David Edelberg, MD