Does your heart occasionally flutter or skip a beat? Does it pound unusually fast or unusually slow? If so, you may have a cardiac arrhythmia, an irregular or abnormal heartbeat that indicates a malfunction in the heart’s electrical system. An arrhythmia may be no big deal—causing no symptoms, sometimes, and presenting no underlying damage or disease—or it could be a very big deal indeed, possibly leading to stroke or sudden cardiac death.

This, in fact, is what happened to political commentator Tim Russert in June. His death is believed to be the result of an arrhythmia caused by the rupture of plaque in his arteries. Especially in this election year, Russert was such a familiar face in American homes that many felt his loss personally—and also worried that they, too, might be vulnerable to such a fate. So it seemed a good time to share with you a bit more about heart arrhythmias, including an exploration of natural options for controlling this common problem. I spoke with two experts—cardiologist Jennifer E. Cummings, MD, director of electrophysiology research at the Cleveland Clinic and Michael Traub, ND, a naturopathic physician in Hawaii and former president of the American Association of Naturopathic Physicians. Both emphasized that anyone who experiences a cardiac arrhythmia should call their doctor and schedule an evaluation.

AT THE HEART OF THE MATTER

The causes for arrhythmia can range from important to insignificant. Cardiac arrhythmia may be triggered by serious, underlying heart disease…more controllable factors such as stress…medications…caffeine…or it may simply be a normal variant that will cause no symptoms or health problems and requires no treatment or lifestyle adjustment. The only way to find out is to work with your cardiologist and undergo medical tests.

Diagnostic tests for heart arrhythmia include a Holter monitor (where your heartbeat is measured over the course of the day as you go about your normal activities), an electrocardiogram (EKG), echocardiogram (heart ultrasound), stress test (a test that measures arrhythmias that are brought on by exercise or stress) or cardiac catheterization (threading a tube into the heart to visualize vessels). There are several distinct kinds of arrhythmia—all potentially dangerous:

• Atrial fibrillaton, a fast and irregular heartbeat that is associated with stroke and heart failure. This is the most common arrhythmia in people over 60.
• Bradycardia, an abnormally slow rhythm that can cause fainting spells and, though only rarely, death.
• Tachycardia, an abnormally fast heart rate that can also cause sudden death.

MAINSTREAM MEDICAL TREATMENTS

Mainstream medical treatments for arrhythmia include drugs, pacemakers and other interventions, surgical or non-surgical. According to Dr. Cummings, the treatment recommendation takes into consideration both the type of arrhythmia and the overall health of the patient. An electrophysiologist (a cardiologist who specializes in treating arrhythmia) can be helpful in exploring the pros and cons of the various treatment alternatives.

Here are some of the most common treatment options…

Antiarrhythmic drugs. Pharmaceutical drugs may be prescribed to block electrical impulses causing the arrhythmia. These work well but the dosage must be carefully monitored and controlled, since paradoxically this class of drugs has also shown an association with an increased risk for a different type of arrhythmia.

Anticoagulant or anti-platelet therapy. Blood-thinning drugs—primarily warfarin or aspirin—may be prescribed to prevent blood clots in people with atrial fibrillation or those at risk for stroke. But, notes Dr. Cummings, aspirin is not for everyone and these treatments are not interchangeable.

Calcium channel blockers and beta blockers. These drugs are prescribed to treat certain abnormal heart rhythms.

Pacemaker and implantable cardioverter-defibrillator (ICD) devices.If non-invasive treatment alternatives aren’t effective or appropriate, your doctor may advise implantation of a pacemaker (to regulate the heart beat) and/or an ICD (to deliver a shock when the rhythm is disrupted, in the hope this will reset the heart to beat more regularly). Typically, slow heart rhythms are treated with pacemakers, while rapid, high-risk ventricular heart rhythms are treated with ICDs.

Radio frequency ablation. A thin, flexible tube called an ablation catheter is threaded into the heart. Pulses of energy get sent through the catheter to the heart, locating and destroying small areas of tissue that are causing the arrhythmias. A similar treatment called cardiac catheter cryoablation accomplishes the same goal, using cold temperatures rather than heat.

THE NATURAL PATH TO CONTROLLING ARRHYTHMIA

Many people may be unaware of simpler tools like lifestyle change, dietary adjustments and natural supplements that may be effective for the treatment of arrhythmias. Dr. Traub told me that in his experience, naturopathic medicine can often be practiced in tandem with conventional medicine to bring an abnormal heartbeat under control.

The first thing to consider is whether making lifestyle changes or successfully controlling underlying conditions can make a difference. For example…

• If you smoke, stop…but (especially if you are a long-timer) seek medical oversight, as your nicotine may need to be tapered.
• Stimulants. If caffeine triggers symptoms, cut back on or eliminate products such as coffee, caffeinated soft drinks, tea, chocolate and anything that contains caffeine. You may need to ease back rather than stop suddenly.
• Over-the-counter cough medicines with pseudo-epinephrine should be avoided, as this is a stimulant that can trigger arrhythmias.
• Limit alcohol intake.
• If you notice that abnormal heart rhythms are associated with specific activities (such as certain stressful family gatherings or particularly demanding exercises), avoid them…at least until you have figured out a way to tolerate such events without having an intense physiological reaction to them. Discuss this with your doctor.
• If a medication appears to bring on symptoms, ask your physician if it is possible to prescribe an alternate drug.
• Take steps to effectively manage stress. There are hundreds of ways to do this—yoga, meditation, exercise, getting a pet, changing jobs. Examine what is contributing stress to your life, and see what can help you better manage or even change it.

NATURAL SUPPLEMENTS FOR TREATING ARRHYTHMIA

Of course, lifestyle changes alone are not always sufficient to control arrhythmias. In more serious cases, Dr. Traub prescribes…

• Fish oil. This rich source of omega-3 fatty acids is step one of Dr. Traub’s treatment protocol. Fish oil is a natural anticoagulant that reduces the risk of blood clots, which can be associated with arrhythmias. Caution: Fish oil should be taken with caution—and only under your physician’s careful supervision—particularly if you take blood-thinning drugs such as warfarin (Coumadin) or aspirin.
• Nattokinase. This extract of the Japanese fermented soybean product natto inhibits development of blood clots. Use with caution—and under a doctor's supervision—if you take other blood thinners.
• Magnesium and potassium. Magnesium and potassium deficiencies may lead to a higher risk of arrhythmias. If blood tests confirm a deficiency, your doctor may prescribe supplements to help restore normal blood levels and reduce arrhythmia risk or occurrence.
• Other supplements. Additional supplements that have shown promise but require further research include Allium cepa and Allium sativum (onion and garlic), Atropa belladonna, Cinnamomum camphora, Cordyceps sinensis and Crataegus oxyacantha. Dr. Traub also points out that acetyl-L-carnitine is used in Europe to treat cardiac arrhythmias.

Cardiac arrhythmia is common—but that doesn’t mean it is safe to ignore it. If you experience even one episode of arrhythmia, call your doctor. You may find that it is nothing at all…or you may learn what you need to do to save your life.

Jennifer E. Cummings, MD, director of electrophysiology research and staff cardiologist, department of cardiovascular medicine, Section of Electrophysiology and Pacing, Cleveland Clinic, Cleveland, Ohio.

Source: Michael Traub, ND, director of the integrated health care center Ho‘o Lokahi in Kailua Kona, Hawaii. Dr. Traub has a part-time practice in Marin County, California and is currently an adjunct faculty member at National College of Natural Medicine, Southwest College of Naturopathic Medicine, University of Bridgeport and the University of Minnesota. He is the former president of the American Association of Naturopathic Physicians.