Atrial Fibrillation

Q) A friend of mine has recently been diagnosed with atrial fibrillation, and I’m looking into alternative treatments. What are the most effective natural remedies you’ve come across for this condition?—C.C., via e-mail

A) Atrial fibrillation (AF) is a form of cardiac arrhyth-mia, or abnormal heart rhythm, characterized by a fast and erratic heart beat. In the UK alone, more than 46,000 new cases of AF are diagnosed every year (BMJ, 2005; 330: 238–43). The condition causes a range of symptoms—from mild fatigue to difficulty in breath-ing, shortness of breath and palpi-tations. While not immediately life-threatening, it increases the risk of stroke or heart failure in some sufferers (Circulation, 2008; 117: e340–3).

Conventional treatment of AF varies, depending on factors such as age, severity of symptoms and whether there’s an underlying cause. Usually, however, a combination of antiarrhythmic and anticoagulant drugs are prescribed, but these, not surprisingly, come with a host of adverse effects. Tiredness, painful joints, loss of taste, dry skin and pink-coloured urine are just a few that have been reported by WDDTY readers.

Happily, there are a number of ways to tackle AF naturally. A word of caution, though: substituting alternative therapies for drugs—especially in cases of a serious heart condition such as AF—should only be carried out under the supervision of an experienced medical practitioner.

Alternative treatments for AF

-            Increase beneficial fats. One promising natural remedy for AF and other arrhythmias is fish oil (omega-3 fatty acids), which appears to have antiarrhythmic effects. A combination of eicosa-pentaenoic acid (EPA) and docosa-hexaenoic acid (DHA) was able to suppress AF in patients under-going coronary bypass grafting. In addition, it’s been demonstrated that omega-3s can reduce sudden cardiac death by 50 per cent (Curr Opin Clin Nutr Metab Care, 2008; 11: 94–9).

However, there’s also evidence that omega-3s might be pro-arrhythmic in some patients with a history of sustained ventricular tachycardia or ventricular fibril-lation, two potentially life-threatening conditions (JAMA, 2005; 293: 2884–91). Although others have failed to confirm these findings, it may be prudent for those with either of these arrhythmias to see a doctor before taking fish oil.

-           Take extra nutrients. Magnesium supplementation in magnesium-deficient patients taking digoxin for arrhythmia allowed their drug dosages to be cut by half (Am J Cardiol, 1986; 57: 956–9). It may even prevent and correct arrhythmias in those who are not magnesium-deficient (Am J Cardiol, 1989; 63: 43G–6G). Supplementing with coenzyme Q10, copper, vitamin C and N-acetylcysteine (NAC) (Tohoku J Exp Med, 1983; 141 [Suppl]: 453–63; Am J Clin Nutr, 1979; 32: 1184–5; Tex Heart Inst J, 2007; 34: 268–74; Eur Heart J, 2008; 29: 625–31) has also proved useful for patients with arrhythmias.

-           Cut the caffeine. Some studies suggest a link between caffeine and arrhythmias, although the evidence is far from clear cut (Am Heart J, 1998; 136: 643–6; J Electrocardiol, 2006; 39: 421–5). It may be that different hearts react differently to caffeine, so the best way to find out if caffeine is affecting your heart is to stop ingesting it and see what happens.

-           Limit alcohol. The evidence that a high alcohol intake causes arrhythmias is more consistent. Heavy drinkers are up to two times more likely to develop AF than those who drink moderately or not at all (Circulation, 2005; 112: 1736–42). One study found a higher risk of AF even among men who consum-ed a moderate two drinks a day (Arch Intern Med, 2004; 164: 1993–8).

-           Stop smoking. Nicotine is a heart stimulant and so can aggravate AF. Cigarette-smoking is also a known risk factor for coronary artery disease (Circulation, 2008; 117: e340–3).

-            Investigate allergies. Allergic reactions to foods and environ-mental chemicals may trigger arrhythmias in susceptible people (Ann Allergy, 1978; 40: 243–51).

-           Try acupuncture. This traditional Chinese form of therapy was nearly 20 per cent more effective in controlling AF than the antiarrhythmic drug amiodarone, and came with no nasty side-effects (Zhongguo Zhen Jiu, 2007; 27: 96–8).

-            Consider herbs. A number of herbal remedies have been tradi-tionally used for arrhythmias, although scientific studies are lacking. Extract of hawthorn berry (Crataegus oxyacantha), for example, significantly reduced arrhythmias—at least in rats, so it may not apply to humans (Basic Res Cardiol, 1999; 94: 71–7). However, a qualified herbalist can advise on the most suitable herbs for your friend’s particular condition.

-           Learn to relax. Stress is a likely trigger of AF in some cases, so taking steps to reduce stress and anxiety may help (Circulation, 2008; 117: e340–3). Breathing exercises, meditation, yoga, tai chi and other techniques can help to keep stress under control.

Some causes of AF

-            Hyperthyroidism (overactive thyroid)

-            Hypoglycaemia (low blood sugar)

-           Acute pulmonary disease (such as pneumonia, asthma, chronic obstructive pulmonary disease or pulmonary embolus)

-            Coronary artery disease

-            Valvular heart disease

-           Heart attack.

From Am Fam Physician, 1994; 50: 959–68