Arrhythmias/Dysrhythmias

Arrhythmias/Dysrhythmias: Overview

An arrhythmia is a change in the rhythm of your heartbeat.  The heart can beat too fast (tachycardia) or too slow (bradycardia).  An arrhythmia can also mean that your heart beats irregularly (skips a beat or has an extra beat). Is an arrhythmia serious? In most people, arrhythmias are minor and not dangerous.  A small number of people, however, have arrhythmias that are dangerous and require treatment.  Arrhythmias are also more serious if you have other heart problems.  In general, arrhythmias that start in the lower chambers of the heart (the ventricles) are more serious than those that start in the upper chambers (the atria).  Your doctor will talk with you about the type of arrhythmia you have and whether you need treatment.

Types of arrhythmias:

  • Atrial fibrillation.  The heart beats too fast and irregularly.  This type of arrhythmia requires treatment and can increase your risk of stroke.
  • Paroxysmal atrial tachycardia (PAT).  The heart has episodes when it beats fast, but regularly.  This type of arrhythmia may be unpleasant but is usually not dangerous.  PAT is an example of an arrhythmia where the abnormality is in the electrical system of the heart, while the heart muscle and valves may be normal.  PAT is susceptible to alcohol excess, stress, caffeine, an overactive thyroid or excessive thyroid hormone intake, and certain drugs.
  • Ectopic beats.  The heart has an extra beat.  Treatment usually is not needed unless you have several extra beats in a row and/or other problems with your heart (such as heart disease or congenital heart failure).
  • Ventricular tachycardia and ventricular fibrillation.  The heart beats too fast and may not pump enough blood.  These types of arrhythmias are very dangerous and need immediate treatment.

Causes and Development

The heart has 4 chambers.  The walls of the heart contract to push blood through the chambers.  The contractions are controlled by an electrical signal that begins in the heart's natural "pacemaker" (the SA node).  The rate of the contractions is influenced by nerve impulses and hormones in the blood.  A problem here, or signals coming from elsewhere, can cause an arrhythmia.

Minor arrhythmias may be caused by excessive alcohol use, smoking, caffeine, stress or exercise.  The most common cause of arrhythmias is heart disease, particularly coronary artery disease, abnormal heart valve function and heart failure.  However, arrhythmias can occur for no known reason.

Signs and Symptoms

At some time or another, most people have felt their heart race or skip a beat.  These occasional changes can be brought on by strong emotions or exercise.  They usually are not a cause for alarm.  Arrhythmias that occur more often or cause symptoms may be more serious and need to be discussed with your doctor.

Diagnosis and Tests

One test that may required for diagnosis is an electrocardiogram, also called ECG or EKG.  You may need to take a treadmill test while your heart is monitored, or monitor your heart while you do your daily activities.  This can be done with a Holter monitor for 24 hours.  Other equipment is available for use when monitoring for more 24 hours.  Further testing may be necessary.

Treatment and Prevention

Treatment depends on the type of arrhythmia you have.  Some mild arrhythmias require no treatment.  Other arrhythmias can be treated with conventional drugs, a pacemaker, defibrillation, radiofrequency ablation or surgery.

Signs, symptoms & indicators of Arrhythmias/Dysrhythmias:

Symptoms - Cardiovascular

Symptoms - General

(Severe) fatigue after slight exertion may be a sign or symptom of Arrhythmias/Dysrhythmias (Severe) fatigue after slight exertion

An inefficient pumping action by the heart can result in rapid fatigue.

Symptoms - Respiratory

Conditions that suggest Arrhythmias/Dysrhythmias:

Mental

Risk factors for Arrhythmias/Dysrhythmias:

Allergy

Environmental Illness / MCS may increase risk of Arrhythmias/Dysrhythmias Environmental Illness / MCS

An irregular or rapid heart beat and awareness of your heart beating are listed as possible symptoms of environmental illness.

Diet

Habits

The Effects Of Overtraining often increases risk of Arrhythmias/Dysrhythmias The Effects Of Overtraining

Endurance sports such as triathlons, ultramarathon running and professional cycling have been associated with as much as a five-fold increase in the prevalence of atrial fibrillation (abnormal heart rhythms).  People who are super-fit are more likely to need pacemakers in old age because exercise causes changes in the body that can disrupt electrical pulses in the heart, causing abnormal heart rhythms.

Metabolic

Hemochromatosis (Iron overload) may increase risk of Arrhythmias/Dysrhythmias Hemochromatosis (Iron overload)

Cardiac arrhythmia occurs in about 7% of symptomatic hemochromatosis patients.

Nutrients

Magnesium Requirement may increase risk of Arrhythmias/Dysrhythmias Magnesium Requirement

Myocardial magnesium was measured in 8 young patients (mean age 32) with ventricular tachycardia of less than 30 seconds in duration who underwent endomyocardial biopsy.  Myocardial magnesium content was lower in the 4 with cardiomyopathic and dysplastic lesions than in the 4 with inflammatory lesions (myocarditis) and 8 controls.  10gm magnesium over 24 hours caused a resolution of ventricular tachycardias and a greater than 80% reduction in ventricular extrasystoles.  No response was seen in the 4 patients with inflammatory lesions.  [Lancet: 1019, 1987]

Respiratory

Obstructive Sleep Apnea (OSA) may increase risk of Arrhythmias/Dysrhythmias Obstructive Sleep Apnea (OSA)

Sleep apnea can also result in cardiac arrhythmias.  Most often, the heart slows while the person stops breathing, and increases when the apneic episode ends.  In 90% of those patients studied with nocturnal bradyarrythmia (slowed heart rate), there was no sign of heart rhythm abnormalities while awake.  Bradyarrhythmias occurred only during sleep and varied considerably in frequency and severity.  [American Heart Journal 2000; 139: pp.142-8]

Arrhythmias/Dysrhythmias suggests the following may be present:

Respiratory

Arrhythmias/Dysrhythmias may suggest Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA)

Sleep apnea can also result in cardiac arrhythmias.  Most often, the heart slows while the person stops breathing, and increases when the apneic episode ends.  In 90% of those patients studied with nocturnal bradyarrythmia (slowed heart rate), there was no sign of heart rhythm abnormalities while awake.  Bradyarrhythmias occurred only during sleep and varied considerably in frequency and severity.  [American Heart Journal 2000; 139: pp.142-8]

Recommendations for Arrhythmias/Dysrhythmias:

Amino Acid / Protein

L-Taurine may help with Arrhythmias/Dysrhythmias L-Taurine

Taurine has been found to be particularly concentrated in the heart with its levels exceeding the combined total of all other amino acids.  During active stress the levels of taurine go up in the heart.  Levels go down after an MI or ischemic attack.  In Japan, taurine is used to treat various types of heart disease.  Some arrhythmias may require IV administration.

Botanical

Olive Leaf Extract may help with Arrhythmias/Dysrhythmias Olive Leaf Extract

European researchers have reported that olive leaf extract could increase blood flow in the coronary arteries and relieve arrhythmias.  There is some testimonial evidence in support of this claim.

Dental

Remove Wisdom Teeth may help with Arrhythmias/Dysrhythmias Remove Wisdom Teeth

Dentists report that the removal of a dead wisdom tooth as well as infected bone in the area has on occasion caused an arrhythmia to disappear.

Detoxification

Heavy Metal Detoxification / Avoidance may help with Arrhythmias/Dysrhythmias Heavy Metal Detoxification / Avoidance

Some doctors have reported arrhythmias improving after mercury amalgam filling removal and systemic treatment with heavy metal chelators.  [Alternative Medicine Digest]

Chelation Therapy may help with Arrhythmias/Dysrhythmias Chelation Therapy

The claim is made by doctors administering EDTA chelation therapy that cardiac arrhythmias frequently disappear when a sufficient number of treatments have been given.  This may be due to the magnesium content.

Diet

Alcohol Avoidance often helps with Arrhythmias/Dysrhythmias Alcohol Avoidance

Atrial fibrillation can be caused by alcohol.

Caffeine/Coffee Avoidance often helps with Arrhythmias/Dysrhythmias Caffeine/Coffee Avoidance

Preventicular contractions can be caused by caffeine.

Hormone

Not recommended
DHEA is sometimes not recommended for Arrhythmias/Dysrhythmias DHEA

Ray Sahelian, MD has reported arrhythmias of different types in individuals using as little as 50mg DHEA or 25mg Pregnenolone.  [TLDP Feb 1998, p.119]

Lab Tests/Rule-Outs

Test Copper Levels may help with Arrhythmias/Dysrhythmias Test Copper Levels

Copper depletion, sometimes seen when taking too much zinc, may contribute to arrhythmias.

Test Thyroid Function may help with Arrhythmias/Dysrhythmias Test Thyroid Function

Atrial fibrillation is 3 times more likely in an elderly person with low TSH.  [Family Practice News Mar 15, 1995]

Mineral

Magnesium often helps with Arrhythmias/Dysrhythmias Magnesium

A magnesium deficiency can produce electrical changes in the heart muscle and thus lead to arrhythmia.  Magnesium is commonly given to patients with arrhythmias but is thought to drive potassium into cells, producing lower serum potassium if not enough potassium is available to maintain normal serum levels.  When in doubt, it is best to supplement both potassium and magnesium together.

Potassium often helps with Arrhythmias/Dysrhythmias Potassium

Potassium deficiency is associated with a slow, irregular heartbeat.  When taking drugs that might deplete intracellular potassium, one should supplement with oral potassium.  Low potassium may cause muscle cramps or worsen an arrhythmia.  Since over-the-counter potassium supplements are limited to 99mg each (about 1/5 that in an average banana), dietary or prescription potassium may be necessary.

Potassium and magnesium may be valuable in preventing tachyarrhythmias in Wolff-Parkinson-White Syndrome.

Nutrient

TMG (Tri-methyl-glycine) often helps with Arrhythmias/Dysrhythmias TMG (Tri-methyl-glycine)

A four-year clinical evaluation of DMG (or TMG) by Mitchell Pries, MD of Palmdale, California has confirmed Soviet findings.  In trials involving the administration of DMG at 125mg bid to over 400 cardiovascular patients, Dr. Pries reported major improvements in several areas including arrhythmias.  This dose is low, and a more rapid response may be possible at higher doses.

Essential Fatty Acids may help with Arrhythmias/Dysrhythmias Essential Fatty Acids

Omega 3 fatty acids may reduce the incidence of arrhythmias during a heart attack.  [Japanese Circulation Journal Dec, 1994;58: pp.903-12]

Physical Medicine

Massage may help with Arrhythmias/Dysrhythmias Massage

In cases of supraventricular tachycardia, stimulation of the vagus nerve is a commonly employed technique to help return the heart rate to normal.  This can be done in several ways:

  • Perform the Valsalva maneuver (briefly strain or bear down as though having a bowel movement)
  • Using one hand, pinch the nose closed with index finger and thumb, while covering your mouth (to provide resistance) and blow out with vigor
  • Pressing/massaging one side of the neck on the carotid artery.  Only press on one side of the neck at a time, not both at once
  • Make yourself gag
All of these techniques serve to stimulate the vagus nerve which slows the heart rate.

KEY

Weak or unproven link: may be a sign or symptom of; may increase risk of; may suggest
Weak or unproven link:
may be a sign or symptom of; may increase risk of; may suggest
Strong or generally accepted link: often suggests; often increases risk of
Strong or generally accepted link:
often suggests; often increases risk of
Definite or direct link: is a sign or symptom of
Definite or direct link:
is a sign or symptom of
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Caution: is sometimes not recommended for
Caution:
is sometimes not recommended for