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Preventing Arrhythmia A Nutritional Guide to Keeping Your Heart in Rhythm

February 2005

By William Davis, MD, FACC

Nearly 10 million Americans suffer from arrhythmia, or an alteration in rhythm of the heartbeat either in time or force. While conventional medical treatments emphasize dangerous anti-arrhythmia drugs, implantable defibrillators, and other major procedures, you can create a powerful arrhythmia-prevention program by following some simple nutritional strategies.

The human heart pumps approximately 100,800 times every day, or about 70 times a minute, every hour of the day, every day of the year.

Your heart’s rhythm, however, is not always as reliable as clockwork. What about that flip-flop feeling you get sometimes while lying in bed? Or that pounding in the chest you felt when your boss berated you on a project or your teenage son pushed you to your limit? When is irregular or rapid heart rhythm just a passing, harmless phenomenon and when is it a harbinger of trouble—real trouble?

In truth, we all have some measure of irregularity to our heartbeats, and no one’s heart rhythm is perfectly regular. Beat-to-beat variation, in fact, is a desirable feature of heart rhythm that indicates good overall health. The most physically fit athletes, for example, have the greatest degree of heartbeat variation.

Heartbeat variability is a reflection of parasympathetic nervous system tone (the opposite of the “fight or flight” sympathetic system), which is the beneath-your-consciousness control system that encourages low blood pressure and feelings of relaxation and calm. People who meditate or use biofeedback can ratchet up their parasympathetic tone and thereby increase their beat-to-beat variation in heart rate. By contrast, lack of beat-to-beat variation can suggest hidden dangers and the potential for heart attack and even death. This lack of variation is not something we can measure ourselves; it must be assessed using an electrocardiogram or extended recording of rhythm. At some point, however, your heart’s rhythm can violate its controls and exceed healthy limits of variability. This condition is called arrhythmia.

Some arrhythmias are benign and simply an annoyance (albeit a frightening one when your heart feels as though it is jumping and racing). Others, however, can be life threatening. How can you tell the difference? And when are nutritional strategies reasonable and a safe alternative or adjunct to conventional therapies?

Understanding Heart Rhythm

Several basic features characterize heart rhythm and can help us understand whether dangers are present or we are just experiencing harmless irregularity.

  • Heart rate. Normal heart rate ranges widely, depending on age, fitness level, mood, physical activity, and fluid intake (including caffeinated beverages). The range considered normal and safe is 50-99 beats per minute. Rates at the lower end suggest fitness, as in the case of long-distance runners. However, heart rate can also decline with age, as the heart’s conduction system slowly degenerates, resulting in the need for pacemakers in some people. Sustained rates at the high end (above 85 beats per minute) can suggest hidden processes such as dehydration, thyroid disorders, infections, and anxiety. In other words, higher heart rates within the “normal” range are non-specific, but can be symptomatic of illnesses or other phenomena not directly involving the heart.

    Heart rates that are less than or greater than the normal range of 50-99 beats per minute are clearly abnormal and should be addressed by a physician. While there is little we can do to influence the development of slow heart rhythms, it is essential that we address fast or markedly irregular heart rhythms.
  • Heart muscle and structure. Imagine that you have experienced several episodes of a rapid heartbeat. You take your pulse and it is 140 beats per minute, lasting around 20 seconds at a time. What does it mean? If you have damaged heart muscle or abnormal heart structure, such as that resulting from a previous heart attack or viral infection (a condition known as viral cardiomyopathy), or a congenital defect, then your rapid heart rhythm can be potentially dangerous, and even life threatening. However, the very same arrhythmia in someone with normal heart structure may be entirely benign or represent an easily treatable condition that presents little or no danger.

    In other words, the same heart rate, and even the same rhythm, can have very different implications, depending on the underlying state of your heart. The crucial question that arises when investigating an arrhythmia is, “What does the heart look like? Are there any structural defects?” These questions must be answered by a physician, usually by imaging the heart with tests such as ultrasound.
  • Symptoms. If you have passed out or felt faint from an arrhythmia, then your condition takes on much greater importance than a rhythm that fails to reach conscious awareness. Being aware of palpitations or that flip-flop feeling in your chest, without feeling faint or losing consciousness, can suggest the presence of an arrhythmia, but palpitations by themselves are exceptionally common and not necessarily related to the heart’s rhythm. For this reason, your doctor will often try to record your rhythm to capture the arrhythmias, if present, should you develop any symptoms.

    Through all this, the heart must maintain its essential function: to pump blood throughout the body. If the heart beats too slow or too fast, or is irregular or otherwise “out-of-sync,” it may struggle to do its job. When the heart’s blood output diminishes, we can become lightheaded, breathless, and even lose consciousness. In the worst case, particularly if the heart structure is significantly abnormal, some arrhythmias can be fatal.

Pros and Cons of Rhythm Medications

Through the years, mishaps and unexpected side effects have plagued arrhythmia-suppressing prescription medications, also referred to as anti-arrhythmics. The drug encainide, for instance, was widely prescribed in the 1980s but withdrawn from the market when reports of serious adverse effects began to accumulate. While this agent was marvelously effective in suppressing arrhythmias, the most dangerous heart arrhythmias of all—ventricular tachycardia and fibrillation, and an unusual rhythm called “Torsade de Pointes”—actually increased with treatment. This and similar experiences underscored that simply suppressing irregular heartbeats may not translate into better outcomes.

Moreover, many anti-arrhythmia medications carry the risk of serious side effects. The agent procainamide, for example, can cause a lupus-like syndrome. Use of amiodarone has been clearly related to thyroid disorders, liver dysfunction, and incapacitating and sometimes fatal lung disease. Tambocor™, a Class I anti-arrhythmic drug, has been associated with an increased risk of mortality. The Life Extension Foundation first reported on the dangers of Tambocor™ in the June 1995 issue of Life Extension, noting that evidence of its risks did not prevent the FDA from approving the drug. Despite a large study by the National Heart, Lung and Blood Institute that showed that Tambocor™ and related drugs had killed a large number of Americans, Tambocor™ remains on the market today. (See also “Cardiac Drugs That Cause Heart Attack,” Life Extension, June 2003.)

Because of their risks, these agents are reserved for the most dangerous heart arrhythmias. The imperfections and pitfalls of rhythm-modulating medications have led many cardiologists to favor implanted defibrillators that deliver an internal shock to the patient to terminate life-threatening arrhythmias. Even in cases of serious arrhythmias, however, nutritional supplements can play a preventive role.

Is There an Ideal Anti-Arrhythmia Treatment?

What would the ideal anti-arrhythmia treatment accomplish? It would eliminate excessive irregular beats and do so with few or no side effects. But it would also protect the heart from dangerous, life-threatening heart rhythms. The ideal anti-arrhythmia treatment would also help curb different varieties of arrhythmias, of which there are several dozen. It is not uncommon, for instance, for a person to have both atrial fibrillation (an irregular rhythm originating from the top of the heart and a risk for stroke) and ventricular arrhythmias (related to a previous heart attack). A single, effective agent for both disorders would be desirable. It might even provide benefits beyond arrhythmia suppression. Unfortunately, no prescription anti-arrhythmia agent on the market today even comes close to qualifying as ideal.

A large body of compelling data argues strongly in favor of certain nutritional approaches to reducing or suppressing some rhythm disorders. While it would be ill advised to treat one’s own arrhythmia, great success can be achieved employing preventive nutritional strategies that may diminish the likelihood of future arrhythmias or lower the frequency and severity of an established rhythm disorder.