Heart palpitations, also called cardiac arrhythmias, are a disturbance in the regular rhythm of the heartbeat. Certain types of heart palpitations are life-threatening and a medical emergency while other types of heart palpitations are not of any major concern. Seek emergency medical help if you also feel faint, dizzy or lightheaded with chest pain or shortness of breath.

Heart palpitations - sensations of a rapid or irregular heartbeat-are most often caused by cardiac arrhythmias or anxiety. Any arrhythmia, including sinus tachycardia, atrial fibrillation, premature ventricular contractions, or ventricular tachycardia, can cause palpitations. Heart palpitations should be considered more serious if they are associated with dizziness, near-syncope, or fainting.

Cardiac arrhythmia simply means that the heart rhythm is irregular, either too fast or too slow. When your heart beats too fast--more than 100 beats per minute--the condition is known as tachycardia. When it beats too slowly--fewer than 60 beats per minute--you have bradycardia.

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

Fish oils -- Fish oils may reduce heart palpitations. 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
Flax seed oil has omega 3 fatty acids and may help, but flax seed oil may not be as effective as fish oil.
Carnitine in amounts less than 100 mg a day
CoQ10 in amounts less than 30 mg a day
Magnesium has been used for heart palpitations
Resveratrol is a natural antioxidant, there is little human research regarding its influence on heart rhythm or heart palpiations.
Berberine and berbamine are potential agents
Hawthorn herb has been tested in rodents and found to have potential benefits against arrhythmias.

Cause of Heart Palpitations
Heart palpitations feel like the heart is pounding or racing. The sensation may also feel like a skipped or abnormal beat, often felt in the chest, neck or throat. The cause of Heart palpitations are many, and it may take a good history and physical to determine which of many reasons is the cause of the heart palpitation. The following are some possibilities:

Heavy exercise, especially in hot weather leading to dehydration.
History of heart disease -- coronary artery disease, stents, heart valve disease such as mitral valve prolapse, myocardial infarction, pericarditis, congestive heart failure, heart attack, cardiomyopathy.
Hyperthyroidism is a common cause of heart palpitation, or mistakenly taking high doses of thyroid hormones.
Hypoglycemia
Prescription medications, particularly amphetamine or stimulant type drugs, diet pills, medications to treat thyroid conditions, asthma, blood pressure can cause a heart palpitation. Even some medication used to treat heart irregularities can sometimes cause it.
Over the counter medicines including cold medicines that have pseudoephedrine or related compounds.
Caffeine found in coffee, tea, cocoa, can, in excess, cause heart palpitations.
Alcohol in excess
Stress and emotions such as fear, anxiety, panic
Dehydration
High fever
Lack of good sleep
Low oxygen in blood, for instance while climbing in high altitudes
Marijuana used in excess, cocaine, drugs that have a stimulant nature.
Natural herbs, supplements, diet pills, and hormones. See below. The hormones DHEA and pregnenolone, can, in high doses, be a cause for heart palpitation.

Diagnosis of Heart Palpitations
Ambulatory electrocardiographic (ECG) monitoring usually is indicated if the etiology of heart palpitations cannot be determined from the patient's history, physical examination, and resting ECG. When heart palpitations occur unpredictably or do 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 palpitations. Trans-telephonic event monitors are more effective and cost-effective than Holter monitors for most patients.

Herbs that could cause Heart Palpitations
Herbs that stimulate cardiac rhythm. Herbs in high doses that may cause heart palpitations include cuscuta, ephedra, ginkgo biloba, ginseng, guarana, horny goat weed, rhodiola, yohimbe, tongkat ali, LJ100, and other tonic herbs. Usually high doses of these herbs cause the cardiac arrhythmia.

Nutrients that can cause Heart Palpitations
Nutrients that can cause an arrhythmia include tyrosine, phenylalanine, high doses of SAM-e.

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

Types of Ventricular Heart Palpitations
     Premature Ventricular Contraction
     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.

Diagnosis of Heart Palpitations
Ambulatory electrocardiographic (ECG) monitoring usually is indicated if the etiology of heart palpitations cannot be determined from the patient's history, physical examination, and resting ECG. When heart palpitations occur unpredictably or do 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 palpitations. Trans-telephonic event monitors are more effective and cost-effective than Holter monitors for most patients.

Heart Palpitations Research Update
[Effect of omega-3 fatty acids on the prevention of atrial arrhythmias]
Ital Heart J Suppl. 2005 Jan;6(1):53-9.
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. METHODS: 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); no changes in the device programmation and in the previous pharmacological therapy were allowed. The devices were interrogated after 4 months of treatment to evaluate the number of episodes and the burden of atrial tachyarrhythmia. At this time, the treatment was discontinued and the patients were reevaluated 4 months later. CONCLUSIONS: Our data suggest a powerful effect of omega-3 fatty acids in the reduction of atrial tachyarrhythmia-fibrillation in these patients, without significant adverse effects.

Dietary flaxseed protects against ventricular fibrillation induced by ischemia-reperfusion in normal and hypercholesterolemic Rabbits.
J Nutr. 2004 Dec;134(12):3250-6.
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the (n-3) PUFA found in fish oils, exert anti-arrhythmic 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 anti arrhythmia in normal and hypercholesterolemic rabbits. This study demonstrates that dietary flaxseed exerts fewer heart palpitations during ischemia-reperfusion in rabbit hearts, possibly through shortening of the action potential.

Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.
Am J Cardiol. 2003 Jul 15;92(2):173-6.
This study was designed to assess the efficacy and safety of berberine for chronic congestive heart failure. One hundred fifty-six patients with CHF and >90 ventricular premature complexes (VPCs) and/or nonsustained ventricular tachycardia (VT) on 24-hour Holter monitoring 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. Symptoms, a 6-minute walk test, left ventricular (LV) ejection fraction (EF), frequency and complexity of VPCs, and quality of life were assessed after 8 weeks of treatment and during a mean 24-month follow-up. After treatment with berberine, there was a significantly greater increase in LVEF, exercise capacity, improvement of the dyspnea-fatigue index, and a decrease of frequency and complexity of VPCs compared with the control group. There was a significant decrease in mortality in the berberine-treated patients during long-term follow-up (7 patients receiving treatment died vs 13 on placebo, p <0.02). Proarrhythmia was not observed, and there were no apparent side effects. Thus, berberine improved quality of life and decreased VPCs and mortality in patients with congestive heart failure.

Fish intake and risk of incident atrial fibrillation.
Circulation. 2004 Jul 27;110(4):368-73.
Mozaffarian D, Psaty BM, Rimm EB, Lemaitre RN, Burke GL, Lyles MF. Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health, Boston, Mass
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is particularly common in the elderly. Although effects of fish intake, including potential antiarrhythmic effects, may favorably influence risk of AF, relationships between fish intake and AF incidence have not been evaluated. In a prospective, population-based cohort of 4815 adults > or =age 65 years, usual dietary intake was assessed at baseline in 1989 and 1990. Consumption of tuna and other broiled or baked fish correlated with plasma phospholipid long-chain n-3 fatty acids, whereas consumption of fried fish or fish sandwiches (fish burgers) did not. AF incidence was prospectively ascertained on the basis of hospital discharge records and annual electrocardiograms. During 12 years' follow-up, 980 cases of incident AF were diagnosed. In multivariate analyses, consumption of tuna or other broiled or baked fish was inversely associated with incidence of AF, with 28% lower risk with intake 1 to 4 times per week, and 31% lower risk with intake > or =5 times per week, compared with <1 time per month. Results were not materially different after adjustment for preceding myocardial infarction or congestive heart failure. In similar analyses, fried fish/fish sandwich consumption was not associated with lower risk of AF. CONCLUSIONS: Among elderly adults, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower incidence of AF. Fish intake may influence risk of this common cardiac arrhythmia.

[Effect of daidzein on antiarrhythmia]
Zhongguo Zhong Yao Za Zhi. 2003 Sep;28(9):853-6.
To study the effect of Daidzein on arrhythmia. RESULT: Daidzein was remarkedly effective in preventing ventricular fibrillation induced by chloroform in mice and arrhythmia induced by aconitine in rats. The arrhythmia induced by adrenalin in rabbits was antagonized by Daidzein and it could obviously inhibit the action potential amplitude of isolated sciatic nerves in toads. And it could also prevent ventricular fibrillation induced by calcium chloride in rats, and obviously reduce the death rate of rats. Its anti-arrhythmic effect was dose-dependent. CONCLUSION: 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.

Heart Palpitations emails and questions
Q. Hi Dr. Sahelian, I just want to say I have really enjoyed taking the supplements you formulate. They work very well. My question concerns your "Passion Rx" (without yohimbe). Recently, I had a little Costochondritis  which has pretty much gone away. The point I'm trying to make is, a physician did an EKG and took blood enzyme tests on my heart at the emergency room of a major hospital and everything came up fine. (I just wanted to give you a little background information). However, sometimes at night, my heart seems to beat very fast sometimes, or sort of beats heavy? or a very pronounced beat. Do you think the "Passion Rx" might be contributing to any of that? (Also, I take the supplements dhea, pregnenolone, and Super Miraforte.) I really hope not, because I like your product.
   A. All three supplements, Passion Rx, DHEA, pregnenolone, and Super Miraforte (which has muira puama and maca) could by themselves can cause the heart beat to be heavier and faster. We do not recommend taking them together since they are all potent. Each one should be taken on a separate day, along with occasional breaks from all supplements. Also, please see the cautions on DHEA and pregnenolone listed on our site. Use the lowest dosage of these supplements that work, even if it is a portion of a capsule or tablet.

Q. Dear Dr. Sahelian, recently I have discovered something that has effectively eliminated heart palpitations from my life and in doing so, has greatly improved my quality of life and I wish to pass along the information to someone who might care enough to use it to help others. Here is the story:
     In the late 1980s I developed hypertension and have been under treatment since that time. I now take both lisinopril and metoprolol tartrate for the hypertension. In the late 1990s I began to develop heart palpitations (atrial). These really bothered me psycologically even though my doctor assured me that they were not life threatening and informed me that he considered the known treatments to be far more dangerous than the palpitations themselves. As a result, I have simply lived with them over the past few years and over that time they progressively became more severe. By March of this year I would experience 20 to 40 minutes of steady heart palpitations every time I would lie down as well as random palpitations the rest of the time. They were beginning to actually make me feel physically sick. During the early part of the year I had also been having a problem with a urinary tract infection as a result of long standing urinary track problems. I was given the choice of treatment with antibiotics or uroquid (a sodium phosphate based drug). I had chosen the uroquid and by March had a very bad reaction to it. One of the results was that it really messed up my stomach. For the stomach problem I began taking aloe vera soft gels of the common variety that are availalble at health food stores and drug stores. I was taking two a day and by the second day I was astounded to realize that the heart palpitations were totally gone. After taking the aloe vera for one month, I stopped it to see what would happen. The heart palpitations returne d within 24 hours. I started taking the aloe vera again and the heart palpitations again stopped. After taking the aloe vera for six months, I again stopped it to see what would happen. This time it took a full week for the heart palpitations to return. Recently, I had a slight problem with some minor palpitations, but found that taking a couple of citrical tabs (one time only) caused them to go away again completely. At this point I am extremely grateful to have the palpitations gone from my life.
     So far I have found one other person with palpitations. In her case the palpitations were a result of a severe physical trauma to the chest. Her doctor was medicating her for her palpitations with something that was making her feel lousy and controlling but not eliminating the palpitations. I suggested she talk to her doctor about the aloe vera. She did and he told her to go for it. I have since been informed that the aloe vera has eliminated her palpitations, the doctor has taken her off of the prescription medication, and that she is feeling better than she has in years. I have also discussed this aloe vera experience with someone at the NIH. This study indicated the aloe vera also may improve lipid and glucose levels in the blood among other things and there is no record that there was any significant follow up to it. My recent blood work done by my physician seems to confirm this since all results from my blood work showed the same patterns of improvement as those in the study. I have since sought out other substances that might help me with my hypertension as well and am now taking fish oil and COQ10 in addition to the aloe vera. I am also trying to follow the dash diet. The overall effect is that my hypertension has been retreating steadily and I am really happy that by accident (or providence) I had this experience with aloe vera. Thank you very much for providing the opportunity to contribute.

Q.  I was on Ritalin and Dexedrine prescriptions several years ago. My heart palpitation began to go very fast over 100 bpm even when I am not exercising. I had since stopped taking both drugs because my ADD was not a problem anymore. But do you know of any herb or natural remedies that would undo the side effect of fast heart palpitation caused by Dexedrine (and possibly Ritalin, too)? I heard passion flower helps to calm palpitation. Does it work?
   A. I am not aware of the role of passion flower in heart palpitation, but some of the nutrients listed at the top of the page may help, so does getting a deep sleep at night and avoiding any kind of stimulant, including coffee and tea.

Q. I read Dr. Sahelian's article on heart palpitations, including where he mentioned that tyrosine or unnecessary thyroid hormone could cause them. Generally speaking, if either of those were the cause of palpitations, would they go away on their own after the supplement or hormone were removed? I understand that a patient would also need a cardiac work-up, but that may diagnose a condition rather than a cause. I was wondering generally whether heart palpitations that were truly caused by a supplement or extra hormone should or would go away on its own and whether there would be an expected time frame.
   A. If the heart had a normal rhythm before the heart palpitations were induced by the thyroid hormone or tyrosine, then the heart should revert back to normality within a few days unless there is underlying heart problem that has not been diagnosed.

Q. I was how long it takes heart for heart palpitations to be considered chronic. I have MVR, and had anxiety attacks about a year and a half ago, and was unable to sleep at night. They got better, on Klonapin, and am still taking it , but was under some stress again, and the palpitations are back and havent been able to sleep again. I have somewhat removed myself from some of the stress but palpitations or sleep isnt better. Does this mean they are chronic now , and that its going to be like this forever, because Im already taking toporol xl but its not really done the trick .
   A. It is impossible for us to say without having full access to your heart studies. In some people heart palpitations are temporary, in others, chronic.

Q. I have noted that Passion Rx is not to be used if you have an irregular heart rhythm. Is there another supplement that is safe to use if one has this heart condition?
   A. Most herbs used for sexual enhancement increase heart contractions are therefore are not recommended to be used by those with heart palpitations. Fish oils could be helpful since they could be helpful in controlling heart rhythm. Perhaps low doses of Prostate Power Rx could be helpful when a capsule is used every other day or every third day. Your doctor needs to approve the use of a natural supplement. There is no guarantee than any product is fully safe.

Q. Recently I began experiencing high blood pressure and some heart palpitations. I had never had this problem before so I started trying to figure out what was causing it. First I thought it was HP8, a prostate supplement with licorice in it, but eliminating it didn’t seem to help, then I eliminated a Beta-Sitosterol supplement but that too didn’t seem to help. I had prostate cancer five years ago so that is why I take those supplements for my prostate and they seem to work well. I continued to eliminate and add foods and the other few supplements I take and I paid close attention to what was happening with my heart. The process took some time. My teeth also started aching when the high blood pressure and heart palpitations came and went. When I had my blood pressure done, it was generally 140/ 90 (in that range). Finally I noticed that the problem only occurred when I ate a homemade crabapple sauce I had made. Now I made about 24 quarts of homemade crabapple sauce this year. Most of it is dark red flavored with honey and cinnamon but one batch was made with very sour slightly bigger crabapples that had pink flesh inside and I flavored that batch with a pumpkin pie spice mix that has nutmeg, cinnamon, and cloves in it. When I eat that batch, my heart races within a few minutes, my blood pressures goes up and my teeth start to ache. It does not happen with the other batches of crabapple sauces. The last time I experimented and waited and ate just two teaspoons of that crabapple sauce on an empty stomach and my heart began racing in about ten minutes. So, now I am wondering what is doing this to me. Is it the really sour small apples I used or one of the spices mentioned above. No one else who has eaten the sour batch with pumpkin pie spices has reacted the way I do. My intuition tells me it is the cloves doing this but why isn’t anyone else who eats that batch experiencing my symptoms?
   A. Some people may have sensitive heart rhythm nodes that are easily disturbed from supplements, on the use of high dosages of supplements over a period of time. Certain spices are potent and could stimulate heart tissue and perhaps cause heart palpitations. Fish oils seem to reduce the risk for heart palpitation.

Q. Hello, I am a 35 year old male with heart palpitations that I've had since I was early 20's, but they seem to become worst with age. Yesterday I had an episode that scared me into a panic attack and I feel like I'm loosing control. My heart rate elevated thus many skipped beats occurred as well as "fluttery" sensations in the heart area. I normally do not feel dizzy or faint but do feel excessive fear with no pain when this occurs. I wanted to hear your feedback on my situation.
   A. There are many causes of heart palpitations that range from mild to serious conditions. A full medical evaluation is required to rule out serious causes.

 

Heart Palpitation Cause