Arrhythmia treatment and prevention with natural supplements, vitamins and herbal extracts by Ray Sahelian, M.D.
April 20 2014

A cardiac arrhythmia, also called heart or cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. Certain types of cardiac arrhythmia are life-threatening and a medical emergency while other types are not of any major concern. Some forms are commonly called heart palpitations by the general population. Those who have a cardiac arrhythmia should review the herbs listed a few paragraphs below and eliminate those that may be causing increased heart rate.

Heart arrhythmia simply means that the heart rhythm is irregular -- such as missing a heart beat or perhaps each beat does not follow the proper rhythm -- or it can also mean the rhythm is too fast or too slow.

Natural or alternative cardiac arrhythmia treatment
Very little research has been done with natural herbs or nutrients in the prevention or therapy of cardiac arrhythmia. I have evaluated some of the published research over the past few years and present the nutrients and herbs that perhaps could be helpful in prevention or treatment. I do not claim that these supplements are a natural cure since more research is needed.

Make sure your fluid intake is good. Drink plenty of water. A decrease in fluid intake can make the heart more prone to irregular rhythms.

Fish oils may reduce ventricular arrhythmia and atrial arrhythmia (most commonly presented as atrial fibrillation). Fish oils and omega-3 fatty acids have been studied for heart arrhythmia more than any other natural supplements. Fish oils stabilize cardiac cell membranes. Doctors who are planning to prescribe anti arrhythmia medicines to their patients for mild cases of arrhythmia should first consider recommending their patients eat cold water fish almost every day and perhaps add one to four fish oil capsules to their daily supplement regimen. Consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower incidence of atrial fibrillation. Fish intake may reduce the risk of this common cardiac arrhythmia.

Effects of fish-oil supplementation on myocardial fatty acids in humans.
Am J Clin Nutr. 2007. Royal Adelaide Hospital, Adelaide, Australia.
The study examined the kinetics of incorporation of n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)  into human myocardial membrane phospholipids during supplementation with fish oil and alpha-linolenic acid-rich flax seed oil. Patients with low self-reported fish intake (<1 fish meal/wk and no oil supplements) accepted for elective cardiac surgery involving cardiopulmonary bypass were randomly allocated to 1 of 6 groups: no supplement; fish oil (6 g EPA+DHA/d) for either 7, 14, or 21 d before surgery; flaxseed oil; or olive oil. In the fish-oil-treated subjects, accumulation of EPA and DHA in the right atrium was curvilinear with time and reached a maximum at approximately 30 d of treatment and displaced mainly arachidonic acid. Flaxseed oil supplementation yielded a small increase in atrial EPA but not DHA, whereas olive oil did not significantly change atrial n-3 fatty acids. The results of the present study show that dietary n-3 fatty acids are rapidly incorporated into human myocardial phospholipids at the expense of arachidonic acid during high-dose fish-oil supplementation.

Effect of omega-3 fatty acids on the prevention of atrial arrhythmias
Ital Heart J Suppl. 2005.
The effects of omega-3 fatty acids on membrane stabilization are well known. Reduction of ventricular arrhythmias and sudden death has been reported; fewer data exist regarding the effects on atrial arrhythmias. The object of this report is to evaluate the reduction of atrial arrhythmia -fibrillation after treatment with omega-3, in patients with dual-chamber pacemakers. We have examined 40 patients with paroxysmal atrial tachyarrhythmia recorded at the periodic pacemaker controls. At the study entry, all patients were treated with omega-3 (1 g/die). Our data suggest a powerful effect of omega-3 fatty acids in the reduction of atrial arrhythmia - fibrillation in these patients, without significant adverse effects.

Flaxseed
Dietary flaxseed protects against ventricular fibrillation induced by ischemia-reperfusion in normal and hypercholesterolemic Rabbits.
J Nutr. 2004.
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the (n-3) PUFA found in fish oils, exert antiarrhythmic effects during ischemia. Flaxseed is the richest plant source of another (n-3) PUFA, alpha-linolenic acid (ALA), yet its effects remain largely unknown. Our objective was to determine whether a flaxseed-rich diet is antiarrhythmic in normal and hypercholesterolemic rabbits. This study demonstrates that dietary flaxseed exerts antiarrhythmic effects during ischemia-reperfusion in rabbit hearts, possibly through shortening of the action potential.

Magnesium has been used for arrhythmia
Carnitine in small doses is worth a try.
CoQ10 also in small doses, such as 30 to 50 mg.

Do you know if taking CoQ10 supplements helps with heart arrhythmias? I have been having the sensation of skipped heart beats but itís really an extra beat. Iím not sure exactly what type of arrhythmia it is but it has caused me a lot of concern as Iím waiting for test results from a Holter Monitor.
    Heart arrhythmias can be caused by a number of factors. It is possible that in a minority of cases CoQ10 could be helpful, but a full evaluation is needed to determine the cause before trying any natural supplements or prescription medications.

Resveratrol is an extract found in wine and grapes. The protective effects of resveratrol on rat heart include reduced rhythm disturbances, reduced cardiac infarct size, and decreased plasma levels of lactate dehydrogenase and creatine kinase.
Potassium is a mineral that can be deficient in some cardiac patients

Berberine and berbamine are potential natural agents that deserve further evaluation.
Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.
Am J Cardiology. 2003.
One hundred fifty-six patients with CHF and >90 ventricular premature complexes (VPCs) and/or nonsustained ventricular tachycardia were randomly divided into 2 groups. All patients were given conventional therapy for congestive heart failure, consisting of angiotensin-converting enzyme inhibitors, digoxin, diuretics, and nitrates. Patients in the treatment group (n = 79) were also given berberine 1.2 to 2.0 g/day. The remaining 77 patients were given placebo. Berberine improved quality of life and decreased VPCs and mortality in patients with congestive heart failure.

Adenosine
Bergenin
Daidzein is effective in preventing ventricular fibrillation induced by chloroform in mice and arrhythmia induced by aconitine in rats. Daidzein has obvious protective effect on drug-induced arrhythmia, which may be related to its inhibition of Na+ or Ca2+ influx and its blocking beta-adrenergic receptor.

Herbs that could cause cardiac arrhythmia
Certain herbs stimulate cardiac rhythm. Herbs in high doses that may cause heart palpitations include excessive intake of licorice, ephedra, ginkgo biloba, ginseng, guarana, horny goat weed, rhodiola herb, yohimbe, and other tonic herbs. Usually high doses of these herbs cause the cardiac arrhythmia.

Ginkgo biloba-induced frequent ventricular arrhythmia.
Ital Heart J. 2002.
In this report, a case of frequent ventricular arrhythmias probably due to Ginkgo biloba is presented. The patient complained of palpitations twice in a month and on both occasions symptoms and electrocardiographic evidence of ventricular arrhythmias resolved with discontinuation of Ginkgo biloba.

Nutrients that can cause heart rhythm disturbances
Nutrients that can cause an arrhythmia include tyrosine amino acid, phenylalanine, and high doses of SAM-e.

Hormones that could cause cardiac problems
Hormones than can cause arrhythmia include high doses of DHEA and pregnenolone, and probably high doses of progesterone or other hormones, including thyroid hormones.

A simple way to bring a rhythm back to normal
In some cases, when an arrhythmia comes on without chest pain, particularly if it is a fast, regular rhythm, lying down on the floor and elevating the legs and feet, hips close to the wall, resting the feet on the wall can rush blood down to the heart and make the heart rhythm come back to normal. Please discuss with your doctor. An arrhythmia is commonly called heart palpitations by the general public.

Potential Causes
History of heart disease -- coronary artery disease, stents, heart valve disease, myocardial infarction, congestive heart failure, cardiomyopathy, and pericarditis.
Hyperthyroidism or overactive thyroid gland can cause arrhythmia, particularly atrial fibrillation
Prescription medications
Over the counter medicines including cold medicines that have pseudoephedrine or related compounds.
Caffeine found in coffee, tea, cocoa
Alcohol, when used in excess, increases the risk for atrial fibrillation
Stress, whether emotional or physical
Lack of good sleep is a common cause
Marijuana overuse
H. Pylori infection of the stomach - may increase risk of atrial fibrillation.
Air pollution may interfere with the heart's ability to reset its electrical properties in an orderly manner.
Certain stimulating natural herbs, supplements, and hormones.

Tachycardia and bradycardia
An arrhythmia can also occur when the heart beats either too fast or too slow. When your heart beats too fast -- more than 100 beats per minute -- the condition is known as tachycardia arrhythmia. When it beats too slow -- fewer than 60 beats per minute -- you have bradycardia arrhythmia. These two arrhythmias are not serious unless they occur in a extreme fashion for prolonged periods.

Types of ventricular arrhythmias
Premature Ventricular Contraction -- an occasional skipped heart beat, occurs in everyone at some time in their life. This is not serious.

Ventricular Tachycardia -- A rhythm of the heart at a rate of more than 100 beats per minute is considered a tachycardia. If the ventricles of the heart experience tachycardia for a sustained period of time, there can be deleterious effects. Individuals may sense a tachycardia as a pounding sensation of the heart; this is known as "palpitations". However, strictly speaking, palpitations are any sensation of an individual's own heart beat, and can occur at rates less than 100 beats/minute.

Ventricular fibrillation -- If fibrillation occurs in the ventricles (lower chambers) of the heart, it is always a medical emergency. If left untreated, ventricular fibrillation can lead to death within minutes. When a heart goes into ventricular fibrillation, effective pumping of the blood stops. The individual goes into cardiac arrest, and will not survive unless cardiopulmonary resuscitation (CPR) and defibrillation are provided immediately.

Atrial fibrillation - atrial and supraventricular
Fibrillation occurs when the heart muscle begins a quivering motion instead of a normal, healthy pumping rhythm. Atrial fibrillation is the quivering, chaotic motion in the upper chambers of the heart, known as the atria. It is often due to serious underlying medical conditions, and should be evaluated by a physician. It is not typically a medical emergency. Some people can live many years or decades with atrial fibrillation.
   Supraventricular Arrhythmia simply means that the arrhythmia is being instigated above the ventricles, which most often means that it is coming from the atria.

Diagnosis
Ambulatory electrocardiographic (ECG) monitoring usually is indicated if the etiology of arrhythmias cannot be determined from the patient's history, physical examination, and resting ECG. When an arrhythmia occurs unpredictably or does not occur daily, an initial two-week course of continuous closed-loop event recording is indicated. Holter monitoring for 24 to 48 hours may be appropriate in patients with daily arrhythmia. Trans-telephonic event monitors are more effective and cost-effective than Holter monitors for most patients.

Sinus Arrhythmia
Sinus arrhythmia means the arrhythmia is being generated from the sinus node.

Symptom and signs
Most people have felt their heart beat very fast, experienced a fluttering in their chest, or noticed that their heart skipped a beat. Almost everyone has also felt dizzy, faint, or out of breath or had chest pains at one time or another. Symptoms of heart arrhythmia may include:

* palpitations (increased awareness of the heart beating faster) This is often the only symptom for most people.
* chest pain
* shortness of breath
* lightheadedness or fainting
* fatigue or weakness

You should not panic if you experience a few flutters or your heart races infrequently, this happens in many people. But if the heart arrhythmia occurs regularly, a doctor's visit is recommended.

Medications Used to Treat Heart Arrhythmias
If the cardiac arryhthmia is caused by a disease, treatment of the underlying disorder is necessary to prevent worsening. Antiarrhythmic drugs may be used to treat rhythm disorders but all of these drugs may cause side effects. Although some patients benefit from them, heart arrhythmias may worsen in 10 or more percent of patients. For that reason and the fact that the more serious heart rhythm abnormalities occur in sick patients, antiarrhythmic drugs are often first given in the hospital, so the effects on heart rhythm can be carefully monitored.

I prefer to use natural supplements and methods first for mild cases of heart arrhythmia, however, moderate to severe cases may require heart arrhythmia medication, such as:

Class 1 Anti-arrhythmic Blocks cardiac sodium channels; slows rate of impulse conduction throughout heart; some drugs also affect potassium channels, altering how long it takes the heart to "reset" after each impulse quinidine (Quinidex, others) phenytoin (Dilantin) flecainide (Tambocor)

Class 2 Anti-arrhythmic Blocks beta receptors, which are chemical docking sites for signals from nervous system; reduces impulse formation in SA node; slows conduction in AV node; reduces force of contractions propranalol (Inderal) acebutolol (Sectral)

Class 3 Anti-arrhythmic Blocks potassium, sodium and calcium channels, and beta receptors (amiodarone); or blocks potassium channels and beta receptors (sotalol); many actions, but mostly prolongs each impulse and prolongs time between impulses amiodarone (Cordarone) sotalol (Betapace)

Class 4 Anti-arrhythmic Blocks calcium channels; reduces formation of impulses in SA node; slows conduction through AV node; reduces force of contractions verapamil (Calan, others) diltiazem (Cardizem, others).