Atrial Fibrillation treatment with natural supplements, diet and food, Prevention and alternative therapy and remedy, by Ray Sahelian, M.D.  
December 20 2014

Atrial fibrillation is a condition in which the heart's upper chambers quiver instead of beating regularly. This arrhythmia increases the risk of stroke, heart failure, cognitive impairment and death. Many people do not experience heart palpitations, shortness of breath or other symptoms that would bring the condition to the attention of a health care provider. Atrial fibrillation is the most common sustained arrhythmia in adults. It is a significant public health problem in the United States where it affects more than 12 million Americans and almost 10% of the population older than 80 years. The prevalence increases with advancing age and with worsening cardiac function. Atrial fibrillation is an independent risk factor for death and greatly increases the risk for embolic stroke. In addition, this arrhythmia can be associated with hemodynamic instability, tachycardia-induced cardiomyopathy, and systemic embolism.
   Despite advances in its medical management over the past two decades, the prognosis of newly diagnosed patients - both in terms of heart failure development and survival if heart failure develops - has not improved. Digitalis treatment poses dangers. See heart arrhythmia for a full discussion and natural treatment options. Treatment aims to keep a patient's heart rate at rest to fewer than 110 beats per minute in those with stable function of the ventricles, the heart's lower chambers.

Adults with diabetes mellitus are at increased risk of subsequent new-onset atrial fibrillation.

Supplements that may benefit atrial fibrillation
Natural methods or natural supplements are rarely used by the medical community in the treatment of atrial fibrillation, but there is early research to indicate that they may be helpful.

Firstly make sure you are well hydrated.
At times lying on one's back on the floor and raising the legs above the head and resting on a wall could help certain types of heart irregularities self-correct.
Gentle physical activity can be of help.

Fish oils reduce arrhythmias up to a point. I wonder if more doctors recommended fish oils, or if patients ate more cold water fish, there would be fewer instances of atrial fibrillation or other types of cardiac arrhythmias and fewer prescriptions would be needed for antiarrhythmic drugs. Also consider eating fish roe which have a lot of omega-3 fatty acids. However, consuming too much of these omega-3 fatty acids may not be a good idea, since there is the possibility of the risk increasing with excessive intake of marine oils. Perhaps it is the omega-3s in them, or perhaps increased intake of iodine or other substances that influence the thyroid gland or the atrial and sinus nodes. Europace. 2014 Feb 26. A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter--a Danish cohort study.
   Studies have shown conflicting results on the benefits of fish oil supplementation and A Fib: Sept. 29, 2014, Journal of the American College of Cardiology, online study did not show benefits.

Magnesium - Dr. Orhan Onalan and colleagues from the University of Toronto reviewed randomized clinical trials on the role of magnesium in the treatment. They compared the effectiveness of magnesium to placebo or antiarrhythmic drugs. Magnesium therapy was much more effective than placebo, and did not have side effects. Dr. Orhan Onalan and colleagues conclude, "intravenous magnesium administration is an effective and safe strategy for the acute management of rapid atrial fibrillation." Am J Cardiol 2007.

Magnesium, at least intravenously, can be helpful in rapid onset atrial fibrillation. Magnesium deficiency in the diet induces heart arrhythmias. Oral use is likely to be of benefit.
Vitamin C may be helpful in some cases.
Oral vitamin C cuts the risk of early recurrence after patients undergo electrical cardioversion. Vitamin C reduces the low-level inflammation that accompanies this condition. Early atrial fibrillation recurrence after cardioversion may be due to electrophysiological changes in the chambers of the heart. A research team randomized 44 patients who had undergone cardioversion for persistent atrial fibrillation to standard therapy plus oral vitamin C or standard treatment only. Patients given the vitamin received a 2-gram loading dose 12 hours before cardioversion and 500 mg twice daily for the next 7 days. One (4 percent) of the patients given vitamin C had a relapse of atrial fibrillation, while eight (36 percent) of patients not given the vitamin did. International Journal of Cardiology, July 2005.
Keep your weight at a normal range since obesity is associated with a higher rate of heart rhythm disturbances.
Avoid excess alcohol consumption.
Consider reducing or eliminating all stimulants including caffeine, some herbal teas, coffee, and herbal supplements. Try to get a deep sleep each night and try to reduce daily stress.

In a small preliminary study,  three sessions of yoga a week reduced the number of of episodes, improved quality of life, lowering levels of the anxiety and depression which often plagues patients with this condition.

J Am Coll Cardiology. 2013. A randomized controlled trial to prevent post-operative atrial fibrillation by antioxidant reinforcement. A total of 203 patients scheduled for on-pump cardiac surgery were randomized to placebo or supplementation with n-3 polyunsaturated fatty acids (2 grams / day) (eicosapentaenoic acid : docosahexaenoic acid ratio 1:2), vitamin C (1 g/day), and vitamin E (400 IU/day). The primary outcome was the occurrence of post-operative atrial fibrillation. Secondary outcomes were the biomarkers related to oxidative stress and inflammation. Post-operative atrial fibrillation occurred in 10 of 103 patients (9.7%) in the supplemented group versus 32 of 100 patients (32%) in the placebo group. Early after surgery, placebo patients presented with increased levels of biomarkers of inflammation and oxidative stress, which were markedly attenuated by antioxidant supplementation. The activity of catalase, superoxide dismutase, and glutathione peroxidase in atrial tissue of the supplemented patients was 24%, 17%, and 19% higher than the respective placebo values. frtThis safe, well-tolerated, and low-cost regimen, consisting of n-3 polyunsaturated fatty acids plus vitamins C and E supplementation, favorably affected post-operative atrial fibrillation, increased antioxidant potential, and attenuated oxidative stress and inflammation.

Q.  You mention fish oil. magnesium, and vitamin C. Have you ever had any feedback or used the amino acid, taurine to treat atrial fibrillation?
   A. I have not had any feedback nor used taurine supplement for atrial fibrillation treatment. A review of Medline in September 2008 did not reveal any studies with taurine in relation to this heart condition.

Q. Are there any contraindications with carnitine, COQ10, magnesium, or potassium when taking blood thinner Xarelto? I have atrial fib and had ministrokes, so was put on Xarelto. I tried Multaq for heart regulation but, was still experiencing some palpitations and just cannot justify taking this because of side effects. I would like to try a more natural approach. If there are no known interactions with these supplements I may give this a short trial. Also was wondering if passion flower would interact.
   A. I have not seen any studies with the combination of this drug rivaroxaban and dietary supplements, so it is difficult to predict.

Supplements that may make A Fib worse
Many dietary supplements can stimulate heart tissue and would not be advised to those with this condition. Some of them include tyrosine, phenylalanine, SAM-e, alpha lipoic acid, ginseng, tongkat ali, yohimbe. There are many others that act as stimulants and I will enlarge this list over time. High doses of vitamin D could be a cause. The first thing to do when you are diagnosed with A Fib is to stop all supplements for a few days.

Diet and lifestyle factors
Reducing lifestyle risk factors such as being overweight, having high blood pressure, high cholesterol or high blood sugar levels, sleep breathing problems (such as sleep apnea), and smoking and drinking can help those with A fib live longer.  University of Adelaide, news release, Dec. 10, 2014.

Atrial fibrillation and stroke
During an episode of AF, abnormal electrical activity in the heart causes its upper two chambers to beat in a rapid, uncoordinated rhythm; the arrhythmia itself is not life-threatening, but over time AF can contribute to stroke or heart failure in some people. Multiple trials have established that antithrombotic therapy decreases stroke risk. Aspirin is associated with a relative risk reduction of about 20% and adjusted-dose warfarin (international normalized ratio 2.0-3.0) is associated with a relative risk reduction of about 60%. Warfarin is more effective than aspirin but is used less often than indicated because of hemorrhagic risk and the inconvenience of coagulation monitoring.

Cause
Scientists do not know all the causes of atrial fibrillation, but its risk factors include high blood pressure, diabetes, heavy alcohol consumption, and valvular heart disease. Recent data have also indicated that obesity is a risk and significant weight loss can make the incidence less common. Obstructive sleep apnea raises the risk.
   A common cause of atrial fibrillation is an overactive thyroid gland.
   Older men who were big during their 20s face an increased risk of suffering from AF. European Heart Journal, online March 20, 2009.
   Having diabetes increases the risk for this heart condition. Diabetes Care, October 2009. Journal of General Internal Medicine, online April 20, 2010.
   Smoking cigarettes can increase a person's chances of getting this heart condition.

Excessive exercise
Vigorous exercise increases the risk but it is helpful to have moderate physical activity.

Obesity as risk factor
Obesity is a cause for developing atrial fibrillation and the risk rises as body mass index (BMI) climbs.

Atrial fibrillation due to prescription medicines
Certain osteoporosis drugs, including Fosamax made by Merck Inc and Reclast by Novartis AG, are linked to atrial fibrillation. Bisphosphonates increase the rates of serious atrial fibrillation. Women who have ever used alendronate, also known by the trade name Fosamax, have an increased risk of atrial fibrillation. Whether the benefits of Foxamax use in terms of fracture prevention in patients with osteoporosis are outweighed by the risks of atrial fibrillation remain to be determined.

The regular use of non-steroidal anti-inflammatory drugs (NSAIDs) and newer anti-inflammatory medications known as cox-2 inhibitors.

Steroid use could also cause atrial fribrillation. Treatment with high doses of corticosteroids, regardless of the indication, increases the risk of new-onset atrial fibrillation. In the May 2006 Archives of Internal Medicine, Dr. Stricker reports that in the Rotterdam Study the risk of new-onset atrial fibrillation was significantly higher in individuals who received corticosteroids. High doses of corticosteroids may affect the balance of potassium in cardiac muscle cells, which may induce arrhythmia or may cause sodium and fluid retention, leading to hypertension, left atrial enlargement and congestive heart failure -- all known risk factors.

H. Pylori
The gastric microbe, Helicobacter pylori, that's the cause of most stomach ulcers also takes it out on the heart. People with rapid beating of the upper chamber of the heart, atrial fibrillation, are nearly 20 times more likely to be infected with Helicobacter than are healthy "controls," according to a report in the medical journal Heart. While the exact mechanism is unknown, the theory is that it may relate to autoantibodies that develop in some H. pylori-infected patients. These antibodies, which normally attack an acid pump found on gastric cells, may instead attack a similar pump on cardiac cells, ultimately triggering atrial fibrillation. The new findings are based on a study of H. pylori tests in 59 patients with atrial fibrillation and 45 healthy controls. In the overall analysis, 97 percent of atrial fibrillation patients were positive for H. pylori compared with just 5 percent of controls.

Atrial fibrillation and alcohol
Those who consume a large amount of alcohol are more likely to experience atrial fibrillation, a heart rhythm problem, than their peers who consume little alcohol. A Fib due to excess alcohol use can occur in men and women.

Atrial fibrillation treatment
The treatment of atrial fibrillation is directed toward the prevention of thromboembolism, control of the ventricular rate and conversion to sinus rhythm. Most people who have atrial fibrillation need more than one type of treatment. Treatment options may include nonsurgical procedures, medications, medical devices such as pacemakers, or surgical procedures. Medications (anti-arrhythmics) are prescribed to restore normal sinus rhythm. The medications effectively maintain sinus rhythm for at least one year in about half of the patients treated. However, atrial fibrillation medications can cause side effects such as nausea and fatigue. Digitalis has serious side effects.

Digoxin, a drug that's been used to treat heart problems for about 200 years, might increase the risk of dying in certain patients. For people who have a particular type of irregular heart rhythm, called AF, taking the drug digoxin may increase the risk of dying.

After surgery for prevention
J Am Coll Cardiol. 2013. A randomized controlled trial to prevent post-operative atrial fibrillation by antioxidant reinforcement.  A total of 203 patients scheduled for on-pump cardiac surgery were randomized to placebo or supplementation with n-3 polyunsaturated fatty acids (2 g/day) (eicosapentaenoic acid:docosahexaenoic acid ratio 1:2), vitamin C (1 g/day), and vitamin E (400 IU/day). This safe, well-tolerated, and low-cost regimen, consisting of n-3 polyunsaturated fatty acids plus vitamins C and E supplementation, favorably affected post-operative atrial fibrillation, increased antioxidant potential, and attenuated oxidative stress and inflammation.

Digitalis side effects - digitalis does not improve mortality
People with atrial fibrillation who are treated with digitalis are at increased risk of death. Dr. Knut Gjesdal of the University of Oslo, Norway have found that digitalis increases exercise capacity and reduces morbidity in patients with heart failure. However, those that take digitalis have no survival benefit. Heart 2008;94:191-196.

New options for atrial fibrillation
New nonpharmacologic possibilities have emerged. These include surgery, radiofrequency catheter ablation, pacing, and atrial defibrillation.

Atrial Fibrillation and cognitive function
Men with atrial fibrillation score significantly lower on cognitive performance tests than their peers without this dangerous heart arrhythmia. A variety of factors link atrial fibrillation to decreased cognitive performance, including undiagnosed stroke, lesions on the brain, and reduced cardiac output. Perhaps medications used to treat atrial fibrillation may also be a factor.

People with atrial fibrillation who are overtreated with anti-clotting drugs may be doubling their risk for dementia. Too much anti-clotting medication may raise the chances of tiny brain bleeds that, over time, might raise the risk of dementia.

Use of natural blood thinners, alternatives to warfarin (Coumadin) and other prescription blood thinners
Two days ago I was diagnosed with A-Fib. My Doctor, prescribed Cardizem 120mg. He also mentioned Coumadin, for the prevention of blood clots. My Doctor explained both medications and risks to me, it was my decision not to take the Coumadin. I started to take the Cardizen two days ago. I would like to know what could you suggest for prevention of blood clots. If you do have any herbal suggestions, can they be taken with the Cardizem?
    There are certain supplements that could be of benefit in this condition and certain herbs that can help thin the blood and I have a list and review at this page blood clot. However, little human research is available regarding the efficacy of these natural approaches and how they compare to the prescription blood thinners. I am not aware of any studies that have looked at the interaction of Cardizem with natural supplements, therefore it is not easy to make any recommendations. if any supplements are taken, the dosage should be low at the beginning and one should proceed cautiously with medical supervision.

Baking soda
I was diagnosed with A Fib and given a script for Carvedilol. I do not feel safe using it. I have been taking baking soda daily. I am 71 years young, exercise moderately 7 days a week.
   I am not familiar with the use of baking soda for this condition.

Research
Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis.
Heart. 2005.
To assess the efficacy of the administration of magnesium as a method for the prevention of postoperative atrial fibrillation. Magnesium administration decreased the proportion of patients developing postoperative AF from 28% in the control group to 18% in the treatment group. Magnesium administration is an effective prophylactic measure for the prevention of postoperative atrial fibrillation. It does not significantly alter LOS or in-hospital mortality.

Marijuana smoking and paroxysmal atrial fibrillation
Harefuah. 2005.  West Galilee Hospital, Naharia, Israel.
Cannabis is the most widely used illegal drug in Israel, and unlike most of the other illegal drugs, it is common among segments of the population with higher demographic characteristics. A healthy 20 year old male patient, with two previous admissions with atrial fibrillation, was admitted to the emergency room with paroxysmal atrial fibrillation. The patient presented evidence of cannabis abuse, and no other pathologic cause for atrial fibrillation. Sinus rhythm was restored and the patient was discharged. Cannabis abuse is responsible for a wide range of pathologies, including cognitive impairment, a rise in the prevalence of lung, head and neck tumors, atrial and ventricular arrhythmias, and an increase in the risk of ischemic cardiovascular events. Cannabis abuse can induce atrial fibrillation in predisposed patients. Good practice may consider the inclusion of cannabis abuse tests in young patients admitted due to atrial fibrillation, and definite medical advice to stop the drug abuse.

n-3 Fatty acids consumed from fish and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.
Am J Clin Nutr. 2005.
Experimental studies have shown that n-3 polyunsaturated fatty acids in fish may have antiarrhythmic properties. We examined the association between consumption of n-3 fatty acids from fish and risk of atrial fibrillation or flutter. In a prospective cohort study of 47 949 participants (mean age: 56 y) in the Danish Diet, Cancer, and Health Study, we investigated the relation between the consumption of n-3 fatty acids from fish estimated from a detailed semiquantitative food questionnaire and risk of atrial fibrillation or flutter. The subjects were followed up in the Danish National Registry of Patients for the occurrence of atrial fibrillation or flutter and in the Danish Civil Registration System (vital status and emigration). The consumption of n-3 fatty acids from fish was analyzed as sex-specific quintiles with the use of Cox proportional hazards models. During follow-up (x: 5.7 y), atrial fibrillation or flutter had developed in 556 subjects (374 men and 182 women). Consumption of n-3 fatty acids from fish was not associated with a reduction in risk of atrial fibrillation or flutter. We cannot exclude the possibility of residual confounding caused by a lack of information on intake of fish-oil tablets.

Emails
Q. Is there a cure for atrial fibrillation?
   A. Depending on the cause, an atrial fibrillation cure is possible. For instance, if this heart condition was due to a hyperactive thyroid, or excess thyroid medication, treating the thyroid problem can lead to a cure. But there are other causes of AF that may not have a full cure.

Q. I have atrial fibrillation and I am taking warfarin, Digitek, and lisinopril. I am a captain and go to sea commercially and since I have problems with easy bleading I wish to get off the warfarin. I have been reading about nattokinase and I have found that not enough study has been done to to provide enough information. Is there a study being done that I could join?
   A. We are not aware of such nattokinase studies for A fib as an alternative to warfarin.

Q. I have at riel fibrillation and cannot have coffee and chocolate. Someone told me I should use carob in place of chocolate – will carob cause heart palpitations? I have been palpitation-free on several meds and do not want to jeopardize this. I am on Coumadin and would like to stop taking it, but causing palpitations with carob would certainly take away the chance of discontinuing Coumadin. Is there caffeine or anything else in carob that would cause palpitations?
   A. Carob does not contain caffeine. However, carob has very small amounts of theobromine. I seriously doubt eating small amounts of carob, or an ounce of chocolate, would aggravate atrial fibrillation.

I have wanted to order Passion Rx but am hesitant. I am a 58 year old male in generally good health. I have had 2 cardiac ablations for Atrial fibrillation which is well under control for several months now. Am taking Diovan, Lotensin hctz, and Caduet for hypertension which is also under good control. I suffer from erectile dysfunction and low sex drive although my testosterone level is in the low-normal range. Do you believe that Passion Rx is safe or is the yohimbe contraindicated for me. If so, do you have a similar sexual enhancement product that I can take?
   Most of the herbs used for sexual enhancement can cause an increase in heart rate and would not be safe for anyone with atrial fibrillation, uncontrolled blood pressure or any type of cardiac disease. However, using very low dosages of aphrodisiac herbs, such as a quarter or a third of a capsule every other day, and being patient for a few weeks, may help some people. It is difficult to say for sure since different people respond differently. A potential supplement that could help with improving sexuality and safe for those with atrial fibrillation would be fish oils. Eating ginger herb daily could also be helpful. Certain sexual herbs and nutrients to consider in low dosage would be maca, ashwagandha, catuaba, CDP-choline and acetylcarnitine. Prostate Power Rx at half a capsule every other day is another option. Again, it is important to emphasize using a low dosage, that means taking a portion of a capsule, and having medical supervision. Passion Rx is too potent and would not be recommended to those with cardiac arrhythmias.

I am 5'10 and weigh 300 pounds and was told that if I lost 50 pounds that my atrial fibrillation would go away. I have been taking Rythmol for 2 years and was quite under control with the Rythmol medication until 3 weeks ago. I am very concerned and do not want to do a ablation. Also, research on the internet, Fibratax keeps showing up as a cure for atrial fibrillation. Do you believe Fibratax is a possible treatment for atrial fibrillation or just another hoax? In your research, if someone were to lose 50-75 pounds, would that stop the atrial fibrillation?
   A search on the internet shows Fibratax to have the following ingredients: Triturated pearls 16 mg, Mastic 12 mg, red-veined salvia, centaurea behen, spiny bamboo, ealy-purple orchid, and other herbs. We are not aware of any human research that has been done with the use of Fibratax as a treatment of atrial fibrillation. There are many causes for atrial fibrillation and perhaps weight loss could help, but even thin people get atrial fibrillation, therefore there are many factors that cause atrial fibrillation besides weight gain or loss.

I take Diltiazem ER for this condition. Do you know if there are any contraindications of taking ashwagandha, Slimaluma (caralluma), or Co Q10 with my Diltiazem medication? Or, are there any contraindications of taking these herbs and vitamins together?
    There is no easy answer since studies have not been done with the combination of heart medications such as Diltiazem and various herbs and herbal extracts. The dosage makes a significant difference. Low dosages, such as a portion of a tablet or capsule may not interfere but higher dosages could.

My father has low blood sugar and would take extra thyroid, as well as energy drinks to help him stay awake at work, not to mention coffee every morning. However, he was diagnosed with atrial fibrillation about 6 months ago when his lungs filled with fluid and we took him to the hospital. Since then, he has deteriorated tremendously. When ever he has trouble breathing or feels ill, he receives steroid and antibiotic shots. In addition to that, he has been put on a list of drugs with the advise not to take certain vitamins as they may have an adverse affect. He still drinks coffee every morning, is still on thyroid medication and is still getting worse. Please help in any way possible. I see that you're currently not taking new patients and that you do not give referrals. So do you have any advice as to what we can do?

I have read your website information with great interest as I have recently developed atrial fibrillation and am looking for a natural remedy for this. I am taking the fish oil as you are suggesting. Please email me the daily quantity you feel would be helpful; I am currently taking 1 teaspoon. I also am a vegetarian, however, I do eat salmon often. I wonder how you would recommend taking flaxseed, quantity and how to take the seeds. I grind them up now and place them in 6 oz. of water first thing in the a.m. I also practice natural hygiene and do not ever take medications. I have also water fasted last year and I am rebuilding my body. I was told by a Naturopathic Doctor that two things trigger this condition. One being any “spices, fried food or irritant” can cause my stomach to trigger A fib. Two, any emotional stress can also trigger a bout with this A fib. My heart has been tested and I’m fine there. I go into this a fib now once a week. It lasts anywhere from 7 hours to mostly 17-18 hours. I stay in bed and juice green drinks. Could you please provide some direction for me. I am a young 65 year old women who is active…gardening, reading, walking, working part timee. Please email me if you have experience with people who are working with this in a natural way.
    I cannot provide personal suggestions, but, as a rule, eating more cold water fish, fish oil capsules, even salmon eggs daily could be beneficial along with the other suggestions on this page.

I receive you news letter and find it informative. My question is about 5HTP. I have artial fibrillation and have had 2 radio frequency ablations for it, but unfortunately, still have some heart arrhythmias. Would 5HTP be of any benefit to me as I do get anxious and mildly depressed with this condition. I do not take any antiarrhythmic or warfarin - just 12.5 mg metoprolol and zolpidem to sleep.
   As far as I know this supplement does not seem to cause heart rhythm problems, but it is difficult to predict what it would do in someone who already has Afib and is taking medications.

I am 40 years old and have had chronic AFIB for several years. A fw months ago I suffered a mini stroke or what the doctors call a transient stroke. After being hospitalized and put on Coumadin, my heart conditioned seemed to worsen and I have not been able to go more than a week without going into Atrial Fib. My episodes last from 12 to 24 hours. I have a hard time knowing whether I have the adrenergic type of lone AF or the vagal type. Although I don’t drink caffeine or alcohol other triggers like excessive salt seems to cause episodes also. I have been on a very low sodium diet for a long time. If I do slip up and have chocolate or coffee, it does become a trigger AFIB as well. Another trigger that is especially frustrating is social anxiety which would lead me to believe I have the adrenergic type which they say is caused by an over active sympathetic nervous system (said to be mainly found in older people). Perhaps I have both types. I hope not!! I don’t fret about visiting or socializing but I do notice that if I visit with more than just a few people in an hours time (like at church) then my heart will go out of rhythm shortly after. This is very frustrating for a homemaker and mother of three. Magnesium foods seem to shorten episodes. Foods like butternut squash and black-eyed peas (they have 270 mg of magnesium per serving).