Irregular heartbeats

Q I have always had irregular heartbeats, but they have not caused any problems. I take digoxin [digitalis, a heart drug] and phenindione [an anticoagulant] daily, but I don’t like taking drugs and I am also allergic to aspirin, antihistamines, omega-3 and -6, and high doses of magnesium.

After a recent EEG, I was told I was at risk of having a stroke, so cardioversion was recommended. I don’t know how effective this will be, but I am sure there must be a more natural way to approach the problem. Certainly, meditation, visualisation, Bach flower remedies and slowing down in general has helped. - CH, Ferndown, Dorset

A Not all arrhythmias are life-threatening. External cardioversion - delivering an electrical shock to the heart to regularise an abnormal heart rhythm - is usually given as an emergency treatment, not for stroke prevention. (Internal cardioversion entails the implantation of a pacemaker.)

You may wish to reassess your medication. Digoxin can actually cause irregular heartbeats (arrhythmias) in some individuals, and phenindione comes with a high risk of adverse effects, such as skin rash, diarrhoea, kidney and liver damage, and leukopenia (having fewer disease-fighting leucocytes in the blood).

It may also prove helpful to investigate the extent of your allergies more thoroughly, as allergies can be an important trigger for arrhythmias (Ann Allergy, 1978; 40: 243-51). For those who are not allergic, magnesium and essential fatty acids are among the most effective treatments for irregular heartbeats. Indeed, low blood concentrations of magnesium are a risk factor for arrhythmias (Am J Cardiol, 1994; 74: 232-5), so supplementation can help (Eur Heart J, 2000; 21: 1116).

In one six-week study, 3.2 g/day of magnesium chloride (the equivalent of 384 mg/day of elemental magnesium) reduced the occurrence of arrhythmias by between 23 and 52 per cent (Am J Cardiol, 1993; 72: 1156-62).

Eating fatty fish, such as salmon, tuna, mackerel and cod, and supplementing with fish oil, can both reduce the risk of developing heartbeat abnormalities. One study found that supplementing with 3 g/day of fish oil (providing 1 g of omega-3 fatty acids) reduced the occurrence of four types of irregular heart rhythms (atrial premature complexes, ventricular premature complexes, couplets, and triplets) by 46.9, 67.8, 71.8, and 100 per cent, respectively (Prostagl Leukotr Essent Fatty Acids, 2004; 71: 153-9). In another, 12-year study, eating fish one to three times per month was linked to a 24 per cent reduction in risk of atrial fibrillation; eating fish five or more times per week reduced the risk by 35 per cent (Circulation, 2004; 110: 368-73).

Other avenues worth exploring include finding out whether you are low in potassium (Am J Cardiol, 1994; 74: 232-5), copper (Am J Clin Nutr, 1979; 32: 1184-5) or selenium (J Am Coll Nutr, 1994; 13: 496-8). Relaxation, as you have already discovered, is also important in the control of abnormal heartbeats.

Hawthorn extract has shown promise in animal studies (Basic Res Cardiol, 1999; 94: 71-7), and many doctors report success with this herb. The usual dose is 80-300 mg of the herbal extract, in the form of capsules or tablets, two to three times a day.

An active constituent in the herb Corydalis is D,L-tetrahydropalmatine (D,L-THP), which appears to have an antiarrhythmic action. This is based on data taken from patients who had a specific type of arrhythmia called ‘supraventricular premature beat’, or SVPB (J Xi’An Med Univ, 1998; 10: 150-3). Finding D,L-THP supplements is difficult, but Corydalis is more widely available.