Cardiac Arrhythmia

Cardiac Arrhythmia

A very frightened father called me asking for help. His six-year-old daughter had been diagnosed with a seriously irregular heartbeat (cardiac arrhythmia).

Arrhythmias are much worse than the more common heart palpitations, a condition in which the heart occasionally seems to skip a beat or two. Heart palpitations are often minor and self-correcting. Cardiac arrhythmias are not. They often don't normalize by themselves, and they can lead to a potentially fatal heart attack. Arrhythmias are usually diagnosed in people over 50, but here was a father telling me that his little girl had this problem.

He told me that his daughter had been taking a calcium channel blocker, a standard type of heart medication, but that it hadn't helped. "Oh, no," I thought. "Now you want to switch to an herbal medicine, and you want me to tell you which one and how much to take."

So I took a breath and was about to deliver my usual spiel: "I don't prescribe, especially for something as potentially serious as cardiac arrhythmia. See your doctor."

But it turned out that when the calcium channel blocker didn't do the trick, the daughter's doctor, of all people, had suggested adding a few natural alternatives to her treatment regimen: hawthorn, coenzyme Q₁₀ and magnesium.

The Natural Route

The herb hawthorn is a traditional heart tonic. And coenzyme Q₁₀ and magnesium have been shown in several studies to help the heart. The father followed the doctor's advice, and he said that the natural approach was working better than the calcium channel blocker had. But now that the daughter was taking hawthorn regularly, the father was naturally concerned about its potential long-term toxicity.

I went to my database and reference books and faxed him what I could find. Hawthorn appeared to be safe for long-term use, but I learned that most people who use it for heart problems (primarily Europeans) are older adults, not children. Curiously, none of my sources at hand said that hawthorn helped treat arrhythmias. In fact, one source said it might cause them. But I found no case reports of heart attacks resulting from using this herb, so I told the worried father that I'd rather give my daughter hawthorn than a calcium channel blocker.

A few months later, the girl's father called again, elated, to share his good news. Just in time for Christmas, his daughter was off the calcium channel blocker completely, thanks to the hawthorn, coenzyme Q₁₀ and magnesium. At her last checkup, her doctor detected no arrhythmia at all. I suggested that he plant a hawthorn tree in his yard to show to people when he recounts his story.

Problems with Rhythm

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.

Arrhythmias are also named according to the part of the heart that is affected. Atrial arrhythmias disturb the heart's ability to pump the blood from its upper chambers, which results in the "pooling" of blood. This stagnant blood can form clots and trigger heart attack or stroke. Ventricular arrhythmias, which affect the heart's larger, lower chambers, can lead to a condition called ventricular fibrillation, a condition in which the chambers quiver weakly instead of contracting vigorously. Ventricular fibrillation is the underlying cause of a substantial proportion of heart attack deaths.

Green Pharmacy for Cardiac Arrhythmia

Cardiac arrhythmia is a serious condition that should be treated by a physician. If I had it, I would certainly take the medications my doctor prescribed. But in consultation with my physician--and many are increasingly open to herbal remedies--I might also try some medicinal herbs.

Angelica (Angelica archangelica). This herb contains at least 14 anti-arrhythmic compounds, one of which is said to be as active as verapamil (Calan, Isoptin), a popular calcium channel blocker. I suggest taking angelica in the form of my Anti-arrhythmic Angelade. To make this tasty cocktail, put angelica, carrots, celery, fennel, garlic and parsnips through your juicer. You may have to add some water and spices to make it drinkable. Heavy with carrots and garlic, it can be quite tasty. I suggest drinking one or two eight-ounce glasses.

Celery contains calcium blockers and other plant chemicals (phytochemicals) such as apigenin, apiin, magnesium and potassium that help prevent and treat arrhythmias, plus other compounds that help lower blood pressure and cholesterol. Garlic also appears to be a potent anti-arrhythmic agent. In studies, laboratory animals that ate garlic powder showed less ventricular tachycardia and fibrillation.

Cinchona (Cinchona, various species). This is the source of quinine, which is famous as a treatment for malaria. Quinine started to gain attention as a remedy for heart problems about a century ago. Legend has it that a Dutch merchant with atrial fibrillation consulted several doctors, who told him there was no remedy. He sought his own remedy and took a gram of quinine. When he returned to his doctors the next day, so the story goes, his pulse was regular.

The key compound is quinidine, now a standard anti-arrhythmic medication. Quinidine is not the only helpful compound in the herb, however; there are more than a dozen. Since you get a few of these compounds when you drink tonic water, I'd drink plenty of tonic if I had arrhythmia.

Hawthorn (Crataegus, various species). Hawthorn is a centuries-old heart tonic, and modern research has confirmed its traditional use. Many studies show that it helps prevent heart problems, gently strengthening the heart muscle, improving blood circulation through the heart and reducing the heart's need for oxygen. It also helps the heart circulate blood with less effort.

Naturopathic physicians recommend taking standardized extracts. The kind of extracts is important, and I'm going to include these details so that you can discuss them with your physician and make sure you are getting the right herbal medication if your doctor gives you the go-ahead to try this. (Notice that naturopaths do not recommend using raw hawthorn. Also note that many states do not require naturopaths to be licensed. If you have any hint of a heart condition, you must look into your naturopath's credentials and training. If you're not sure whether to proceed, discuss it with your regular physician.)

The recommended extracts contain 1.8 percent vitexin-4-rhamnoside or 10 percent oligomeric procyanidins (OPCs) in dosages of 120 to 240 milligrams three times a day. If the extracts are standardized to 18 percent OPCs, the recommended dosage is 240 to 480 milligrams once a day. To obtain these extracts, you must consult a naturopath.

There have been scattered reports that hawthorn may increase arrhythmias in some cases. I don't put much stock in these reports, but it's better to be safe than sorry. You really need to be monitored by a doctor if you try this herb.

Canola (Brassica, various species). Australian cardiologists have shown that dietary canola oil helps prevent cardiac arrhythmias in laboratory animals. I bet that it would also help in people.

Khella (Ammi majus). Khella is the source of amiodarone (Cordarone), one of the key anti-arrhythmia medications. London cardiologist Arthur Hollman, M.D., tells the story of the development of this drug in his book Cardiology from Nature, which is a tribute to the powers of natural medicine.

Back in 1946, a technician in the medical research laboratory of G. V. Anrepin, M.D., developed a kidney problem and treated himself with a Middle Eastern herbal remedy, khella.

As fate would have it, the technician also had angina, which improved dramatically while he was taking the herb. Intrigued by this unexpected benefit, Dr. Anrepin studied the plant and isolated its active ingredient, khellin. Further work elsewhere led to the development of khellin-derived amiodarone, which was originally used to treat angina. Eventually, in 1974, its unique anti-arrhythmic activity was discovered.

It is possible to get some benefit from taking the herb itself to treat arrhythmia. The usual recommendation calls for pouring boiling water over about a quarter-teaspoon of powdered khella fruits. Steep for five minutes and drink the tea after straining.

Astragalus (Astragalus, various species). Also known as huang qi, astragalus is best known as an immune stimulant. According to California herbalist Kathi Keville, author of The Illustrated Herb Encyclopedia and Herbs for Health and Healing, it is also a heart tonic that helps prevent and treat arrhythmia. You can try a tea made with one to two teaspoons of dried herb steeped in boiling water.

Barberry (Berberis vulgaris). Barberry is best known as an herbal antibiotic because it contains berberine, a compound also found in goldenseal. Berberine also helps prevent and treat ventricular arrhythmias, according to Melvyn Werbach, M.D., assistant clinical professor of psychiatry at the University of California, Los Angeles, School of Medicine and author of Nutritional Influences on Illness.

In one Chinese study, berberine reduced ventricular arrhythmias by more than 50 percent in more than half of the people who used it. In addition to goldenseal, other herbs with berberine include Oregon grape and goldthread.

The best way to take this herb is to buy a standardized herbal extract at a health food store or herb shop and follow the package directions. It is possible to make a tea using a teaspoon or two of the dried herb to a cup of boiling water.

Barberry Along with its close relative Oregon grape, barberry may stimulate the immune system and help fight damage from free radicals.

Ginkgo (Ginkgo biloba). Ginkgo is a favorite Chinese heart tonic. I know of no studies showing that ginkgo has anti-arrhythmic effects, but like hawthorn, it improves blood flow to the heart and lessens coronary demand for oxygen, thus reducing shortness of breath and chest pain. If I had an arrhythmia, I would include ginkgo among my herbal treatments.

You can buy ginkgo extracts at many health food stores; follow the package directions. You can try 60 to 240 milligrams a day, but don't go any higher. In large amounts, ginkgo may cause diarrhea, irritability and restlessness.

Horehound (Marrubium vulgare). Horehound is best known as a treatment for coughs and colds because the two key compounds it contains, marrubiin and marrubic acid, are good expectorants. But these compounds also have a normalizing effect on heart rhythm. You can make a tea using two to three teaspoons of the herb and drink a cup after lunch and dinner.

Motherwort (Leonurus cardiaca). With a name like cardiaca, this herb might be expected to help heart problems, and science confirms that it does. Chinese studies show that it slows a rapid heartbeat, generally improving cardiac activity. It also helps tranquilize the nervous system, reducing the anxiety, nervous tension and stress that may accompany or trigger heart problems.

The Chinese reportedly consume as much as nine ounces (250 grams) a day. That sounds like a bit much to me. I'd suggest trying about a half-ounce in three cups of boiling water for two or three days to see if it helps.

Purslane (Portulaca oleracea) and other plants containing magnesium. According to estimates I've seen, more than 70 percent of Americans may get insufficient magnesium. Maybe that's why we have so much arrhythmia. Scientists note that magnesium, at doses of 250 milligrams a day, helps prevent cardiac arrhythmia.

Purslane is very rich in magnesium (nearly 2 percent on a dry-weight basis). Green beans, poppy seeds, oats, cowpeas and spinach are also good sources. In season, I cook purslane like spinach and eat several ounces at a time.

Reishi (Ganoderma lucidum). Sixteenth-century Ming Dynasty texts say that this marvelous Chinese medicinal mushroom "mends the heart." And my good friend, pharmacognosist (natural product pharmacist) Albert Leung, Ph.D., says in his Better Health with (Mostly) Chinese Herbs and Food that reishi has considerable value in preventing and treating arrhythmia.

Reishi is a heart tonic, like hawthorn and ginkgo. It improves blood flow to the heart, reduces coronary demand for oxygen and helps ease the chest pain of angina. I make reishi tea using three to six teaspoons of dried herb per cup of boiling water.

Scotch broom (Cytisus scoparius). This herb is useful as a heart tonic, according to Commission E, the German expert committee that judges the safety and effectiveness of herbal medicines. The principal active constituent is an anti-arrhythmic compound, sparteine.

You can make a tea using one teaspoon of dried herb per cup of boiling water. Drink up to two cups a day. One note of caution: Scotch broom also contains the compound tyramine, which means that it should not be used with the class of antidepressant medications known as MAO inhibitors. If you take an antidepressant, find out if it's an MAO inhibitor, and if it is, don't use this herb.

Valerian (Valeriana officinalis). Valerian is best known as an herbal sleep aid, and with good reason. But herbal pharmacologist Daniel Mowrey, Ph.D., author of The Scientific Validation of Herbal Medicine and Herbal Tonic Therapies, says that valerian also contains proven anti-arrhythmic compounds. In fact, this herb was used for arrhythmias and palpitations in Roman times.

Valerian also has other heart benefits: It lowers blood pressure, increases blood flow to the heart and improves the heart's pumping ability.

This herb smells pretty foul, but in spite of this, I'd try a tea made with one to two teaspoons of dried herb per cup of boiling water. Drink two to three cups a day. If you can't handle the taste, try capsules or a tincture instead. Both the dried herb and tincture are available at health food stores or herb shops. Follow the package directions.