PCC | Healthnotes | Cardiac Arrhythmia

Cardiac Arrhythmia

Also indexed as: Atrial Fibrillation, Heart Arrhythmia, Irregular Heartbeat, Sick Sinus Syndrome, Supraventricular Premature Beats, Ventricular Premature Beats

When your heart skips, you may feel dizzy or anxious. Although an irregular heartbeat is often harmless, it should be treated with care. According to research or other evidence, the following self-care steps may be helpful:

Cut the caffeine
Reduce the frequency of some arrhythmias by cutting back on coffee and other caffeinated products

Mix in some magnesium
Under a doctor’s supervision, take daily supplements containing 350 to 400 mg of this essential mineral for fewer episodes

Check out potassium
Ask your doctor if 1,000 mg a day of this essential mineral may help treat your arrhythmia

Don’t forget the fish oil
Take capsules containing 2.4 grams of heart-healthy omega-3 fatty acids every day to reduce the frequency of irregular heartbeats

See a heart-health expert
Visit a healthcare professional knowledgeable in cardiology to get a thorough evaluation, and for supervision when using natural substances to treat cardiac arrhythmia

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full cardiac arrhythmia article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About cardiac arrhythmia

Cardiac arrhythmia is a term that denotes a disturbance of the heart rhythm.

Cardiac arrhythmias can range in severity from entirely benign to immediately life-threatening. If arrhythmia is suspected, a doctor should be consulted for confirmation. In addition, the use of natural substances for arrhythmia should always be supervised by a doctor.

Product ratings for cardiac arrhythmia

Science Ratings	Nutritional Supplements	Herbs
	Magnesium
	Fish oil (do not take, or take only with a doctor's supervision, if there is a history of sustained ventricular tachycardia or ventricular fibrillation) Potassium
	Copper Selenium Vitamin D	Corydalis Hawthorn
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Most arrhythmia does not result in symptoms, but people may experience anxiety, lightheadedness, dizziness, fainting, unusual awareness of the heartbeat, and sensations of fluttering or pounding in the chest.

Dietary changes that may be helpful

Excessive caffeine consumption has been associated with arrhythmia in human studies. Although most people do not experience arrhythmia as a result of caffeine consumption,¹ some healthy people appear to be susceptible to as little as one cup of coffee.²

Allergic reactions to foods and environmental chemicals have been reported to trigger arrhythmias.³ Consultation with a physician may help to pinpoint these sensitivities.

Other therapies

Medical conditions that may cause arrhythmia, such as anemia, fever, heart failure, or electrolyte imbalance, are treated accordingly. In some cases, a synchronized electrical shock (defibrillation) is applied to the heart either externally or internally (from a previously implanted device that automatically activates when a life-threatening arrhythmia is detected). When a normal rhythm cannot be established by these methods, a pacemaker (an electronic device that controls the rhythm of the heart) may be implanted surgically. A newer procedure called radiofrequency ablation may be used to destroy small areas of the heart responsible for the arrhythmia.

Vitamins that may be helpful

A double-blind trial investigated the effect of oral magnesium supplementation on arrhythmic episodes in people with congestive heart failure. Those people taking 3.2 grams per day of magnesium chloride (equivalent to 384 mg per day of elemental magnesium) had between 23% and 52% fewer occurrences of specific types of arrhythmia during the six-week study, compared with those taking placebo.⁴ Lower serum concentrations of magnesium were found to be associated with a higher incidence of arrhythmia in a large population study.⁵ The anti-arrhythmic properties of magnesium appear to be specific. For example, magnesium is clearly able to prevent a drug-induced arrhythmia called torsade de pointes,⁶ but it does not appear to prevent atrial fibrillation.⁷ A doctor should supervise any use of magnesium for cardiac arrhythmia.

In a double-blind trial, people with a type of arrhythmia known as ventricular premature complexes were supplemented for 16 weeks with either 15 ml (1 tbsp) per day of fish oil or a similar amount of safflower oil as placebo. Patients taking the fish oil had a significantly reduced frequency of abnormal heartbeats compared with those receiving placebo, and 44% of those receiving fish oil experienced at least a 70% reduction in the frequency of abnormal beats.⁸ In a separate study, however, men given 20 ml (4 tsp) of cod liver oil per day for six weeks, beginning one week after a heart attack, had the same frequency of irregular heart beats as did men given no supplemental oil.⁹ In a double-blind study, people who had a history of certain potentially life-threatening arrhythmias—sustained ventricular tachycardia or ventricular fibrillation—had an increase in the recurrence rate of these arrhythmias when they took fish oil.¹⁰ A similar study found no adverse effect of fish oil supplements in people with these serious arrhythmias.¹¹ Because of these conflicting findings, people with a history of either of these arrhythmias should consult a doctor before taking fish oil.

Patients taking hydrochlorothiazide for high blood pressure had a significant reduction in arrhythmias when supplemented with 1 gram twice per day of potassium hydrochloride (supplying 1040 mg per day of elemental potassium). Those results were not improved by adding 500 mg twice per day of magnesium hydroxide (supplying 500 mg per day of elemental magnesium) to the potassium.¹² Low serum concentrations of potassium were found to be associated with a higher incidence of arrhythmia in a large population study.¹³

Three cases have been reported in which ventricular premature beats disappeared after supplementation with copper (4 mg per day in the two cases for which amounts were reported).¹⁴ In one of these people, supplementing with zinc made the arrhythmia worse, confirming previous observations that excessive zinc intake may lead to copper deficiency,¹⁵ which in turn may lead to arrhythmia.

Gross deficiency of dietary selenium may cause many heart problems, including arrhythmia. Based on this finding, one author has theorized that correction of low selenium status may improve many arrhythmias, even in the absence of overt deficiency symptoms.¹⁶ Controlled research is needed to evaluate this possibility.

One case of long-standing sick-sinus syndrome (another type of arrhythmia) was reported to resolve upon supplementation with 800 IU per day of vitamin D prescribed for an unrelated condition. However, it was not clear from that report whether the improvement was due to the vitamin D.¹⁷ More research is needed.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful

An animal study showed that an extract of hawthorn significantly reduced the number of experimentally induced arrhythmias.¹⁸ Although the use of hawthorn for arrhythmia in humans has not been studied scientifically, it traditionally has been used for this purpose.¹⁹

An active constituent in corydalis, dl-tetrahydropalmatine (dl-THP), may exert an anti-arrhythmic action on the heart. This action was observed in a preliminary trial with 33 patients suffering from a specific type of arrhythmia called supraventricular premature beat or SVPB.²⁰ Each patient took 300 to 600 mg of dl-THP per day in tablet form, and the dl-THP was found to be significantly more effective than placebo in reducing arrhythmia.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

References
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1. Donnerstein RL, Zhu D, Samson R, et al. Acute effects of caffeine ingestion on signal-averaged electrocardiograms. Am Heart J 1998;136:643–6.

2. Dobmeyer DJ, Stine RA, Leier CV, et al. The arrhythmogenic effects of caffeine in human beings. N Engl J Med 1983;308:814–6.

3. Rea WJ. Environmentally triggered cardiac disease. Ann Allergy 1978;40:243–51.

4. Bashir Y, Sneddon JF, Staunton A, et al. Effects of long-term oral magnesium chloride replacement in congestive heart failure secondary to coronary artery disease. Am J Cardiol 1993;72:1156–62.

5. Tsuji H, Venditti FJ, Evans JC, et al. The associations of levels of serum potassium and magnesium with ventricular premature complexes (the Framingham Heart Study). Am J Cardiol 1994;74:232–5.

6. Tzivoni D, Keren A. Suppression of ventricular arrhythmias by magnesium. Am J Cardiol 1990;65:1397–9 [review].

7. Brugada P. Magnesium: an antiarrhythmic drug, but only against very specific arrhythmias. Eur Heart J 2000;21:1116 [review].

8. Sellmayer A, Witzgall H, Lorenz RL, Weber PC. Effects of dietary fish oil on ventricular premature complexes. Am J Cardiol 1995;76:974–7.

9. Hardarson T, Kristinsson A, Skuladottir G, et al. Cod liver oil does not reduce ventricular extrasystoles after myocardial infarction. J Intern Med 1989;236:33–7.

10. Raitt MH, Connor WE, Morris C, et al. Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators. A randomized controlled trial. JAMA 2005;293:2884–91

11. Brouwer IA, Zock PL, Camm AJ, et al. Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defibrillators: the Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) randomized trial. JAMA 2006;295:2613–9.

12. Lumme JA, Jounela AJ. The effect of potassium and potassium plus magnesium supplementation on ventricular extrasystoles in mild hypertensives treated with hydrochlorothiazide. Int J Cardiol 1989;25:93–8.

13. Tsuji H, Venditti FJ, Evans JC, et al. The associations of levels of serum potassium and magnesium with ventricular premature complexes (the Framingham Heart Study). Am J Cardiol 1994;74:232–5.

14. Spencer JC. Direct relationship between the body’s copper/zinc ratio, ventricular premature beats and sudden cardiac death. Am J Clin Nutr 1979;32:1184–5 [letter].

15. Porter KG, McMaster D, Elmes ME, Love AH. Anaemia and low serum-copper during zinc therapy. Lancet 1977;2:774 [letter].

16. Lehr D. A possible beneficial effect of selenium administration in antiarrhythmic therapy. J Am Coll Nutr 1994;13:496–8.

17. Kessel L. Sick sinus syndrome cured by...vitamin D? Geriatrics 1990;45(8):83–5.

18. Al Makdessi S, Sweidan H, Dietz K, Jacob R. Protective effect of Crataegus oxycantha against reperfusion arrhythmias after global no-flow ischemia in the rat heart. Basic Res Cardiol 1999;94:71–7.

19. Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy. Sandy, OR: Eclectic, 1919, 217–20.

20. Xiaolin N, Zhenhua H, Xin M, et al. Clinical and experimental study of dl-tetrahydropalmatine effect in the treatment of supraventricular arrhythmia. J Xi’An Med Univ 1998;10:150–3.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires September 2008.