Q:A few years ago I was diagnosed with tachycardia abnormally rapid heartbeat which I am told is caused by my ME. For over a year I was severely ill and needed a wheelchair to go out. I am better now but my heart is still a big problem. As soon as
A:Individuals suffering from tachycardia may experience heartbeats ranging from 103 to 300 beats per minute. There is no agreement on what causes this condition, nor is there any agreement on how best to manage it. In younger individuals, tachycardia is usually present without any detectable signs of heart disease and is not usually associated with a high death rate. In older individuals the risk is greater (Am Heart J, 1993, 126: 1194-8).
Doctors would usually treat by prescribing a course of beta blockers, verapamil and adenosine. Beta blockers can, however induce sudden, irregular heartbeats (Lancet, 1996; 348: 7-12) and verapamil and adenosine can cause a host of reactions, including nausea, headaches, blurred vision, chest pain, dizziness, vertigo and allergic reactions.
Exercise induced tachycardia, where you have rapid heartbeat on exertion, may also be a side effect of the drug digitalis (used to treat heart failure) (Clin Cardiol, 1993; 16(3): 270-2).
Your best approach may be a multifactoral one which involves diet, alternative therapies, and, yes, some form of relaxation or stress management.
Your attacks may well be linked to your ME, but they are most likely to be a part of the overall picture of symptoms you are suffering, rather than a direct cause. ME sufferers experience a wide range of symptoms, including panic attacks, from time to time. Panic can increase heart rate so first you might ask yourself whether your doctor has labelled your condition for his own convenience, rather than for accuracy.
While there are tests which you can have to confirm a diagnosis of tachycardia, this may reveal little of any positive value. Although it is possible to identify a significant proportion of individuals with tachycardia who have abnormalities in cardiac size or function, it is difficult to determine whether these abnormalities are directly related to the problem of abnormally strong heart beats (Circulation, 1989; 79: 990-99).
Acupuncture may be helpful. George Lewith, an acupuncturist (and panel member on our sister publication Proof!), says that, when tachycardia is a new problem, "acupuncture can be effective in up to 70 per cent of cases". However, once the problem is well established, acupuncture is only successful in a small percentage of cases. Although research findings about acupuncture are mixed, two studies have shown that acupuncture can help increase the work capacity of the heart (J Clin Epidemiol, 1990, 43: 1191-9) and reduce hypertension (J Trad Chin Med, 1992; 12: 133-6).
Several herbs can help normalize heart rhythms. Hawthorn has been used as a general heart tonic and has been proven effective in several trials in treating heart arrhythmias (irregular heart beat) (Planta Med, 43: 209-39 and 43: 313-22). The dosage should be a standardized extract of around 120-240mg three times daily.
Ginkgo biloba increases blood flow to the brain. In one double blind French trial, those receiving ginkgo were able to walk longer distances than controls (Weiner Medisinische Wochenschrift, 1989; 139: 92-4).
Berberine, an alkaloid extracted from the roots and bark of various plants such as goldenseal, barberry root bark and Oregon grape root, may also help to lower the heart rate of patients with ventricular tachyarrhythmias, according to one Chinese study (J Chun Hua Hsin, Hsueh Kuan Ping Tsa Chih, 1990; 18(3): 155-6, 190).
Magnesium has been shown to help heart conditions and ME. One study found that two thirds of ME sufferers had lower red cell magnesium concentrations than did healthy controls (Lancet, 30 March, 1991) and that after being given intravenous magnesium sulphate, ME sufferers reported improved energy levels, better emotional states and less pain.
Dr David Dowson, who conducted the study, found that oral magnesium supplements were generally insufficient to correct deficiencies, which required injected supplements.
Other researchers have speculated that injections won't work unless preceded by several months of oral supplementation. Since performing his research, Dr Dowson has discovered that patients who take oral supplements of selenium at the same time as magnesium injections seem to do better. Remember, however, that selenium can be toxic in high doses no more than 200 mcg per day should be taken).
Besides helping with ME, magnesium supplementation has been shown to have a marked beneficial effect on heart arrhythmias (Am J Cardiol, 1989; 63: 43G-46G; Am J Cardiol, 1986; 57: 956) particularly if these arrhythmias are caused by the drug digitalis (JAMA, 1983; 249: 2808-10).
If you have tachycardia, our panelist Melvyn Werbach recommends, in his book, Nutritional Influences on Illness (Third Line Press, 1993), that you should also try to rule out food and chemical sensitivities, since ingesting an offending substance tends to cause sudden rapid heartbeat. Melvyn Werbach cites two patients where symptoms cleared up after investigating and eliminating allergens.
It is unlikely that you should be exercising more, as pushing yourself too hard may only aggravate your condition and keep you in a vicious circle.