ATRIAL FIBRILLATION: Cautions on a Common Part of Aging

Every year around 75,000 Americans learn that they have atrial fibrillation (popularly known as AFib), the most common type of arrhythmia, or abnormal heart rhythm. While the abnormal heart rhythm itself isn't generally serious, the abnormal blood flow and strain to the heart it may cause can result in serious medical consequences. And having AFib doubles a person's risk of death. Over the past decade, both the incidence and prevalence of atrial fibrillation has markedly increased and, with it, the total number of patients potentially requiring long-term care. In 2009, the estimated number of atrial fibrillation diagnoses in the United States was 2.6 million with an equal distribution between men and women and well over three quarters over age 65. AFib can be either sporadic, in which case it is called paroxysmal atrial fibrillation, or chronic.

Causes of A-fib

What causes A-fib? When the heart beats, the atria (the two upper chambers of the heart) and the ventricles (the two lower chambers) alternately contract and relax in a rhythm to pump blood to your lungs and the rest of the body. These contractions initiate in a bundle of cells in the right atrium called the sinoatrial (SA) node, which then spreads electrical impulses through the atrial walls.

Over time, the atria stretch, making them more likely to fibrillate, and islands of fibrous tissue develop on the walls of the atrium, creating obstacles to the conduction of the heart's electrical impulses. Instead of going straight through the atria (as they should) the impulses spiral and stray, causing atrial fibrillation. The heart rate in AFib may range from 100 to 175 beats a minute; (The condition known as Atrial flutter is very much similar to AFib with respect to symptoms, causes and risk factors, but the heart rate in this condition is much slower).

Aging is also associated with stiffening of the arteries, which results in high blood pressure and increases the workload of the heart. In addition to stretching the atria, over time this increased workload can thicken the muscle walls of the ventricles through a process called ventricular hypertrophy. This added stress makes the heart more irritable, resulting in extra beats that can become risk factors for atrial fibrillation. Lung diseases such as emphysema and sleep apnea can also cause atrial fibrillation and in addition, atrial fibrillation may occur following major surgery. Sometimes the cause simply isn’t clear.

The rapid and irregular beating of the heart that occurs with atrial fibrillation can allow a blood clot to form in the atria. If a blood clot breaks off and goes to the brain, it will cause a stroke. The type of stroke and symptoms will depend on where the clot goes in the brain. To decrease the risk of stroke, medicines that prevent blood clots from forming in the heart are often used in the treatment of atrial fibrillation.

Are there any noninvasive, natural remedies that might supplement or even supplant cardiac electro-ablation and the use of anticoagulants, which carry in their wake their own set of dangers? The clinical results of treating A-fib with alternative approaches have been mixed, but promising.

Herbal Care for the Heart

Herbs for atrial fibrillation may include some of the following:

• Marich Phalam (Cayenne pepper: strengthens the heart, increases circulation, may normalize blood pressure)
• Basangli (Hawthorn berry, increases heart circulation, good for irregular heart rate, eases angina)
• Lashona (Garlic, opens clogged arteries, helps irregular heart rate)
• Dong quai (strengthens the heart muscle)
• Motherwort (slows overly fast heart rate)
• Angelica (anti-arrhythmia)
• Astragalus (increases cardiac output)

Using herbs for your heart arrhythmia is a great life-transforming type of therapy and it’s for your good health. But realize that you won’t be giving up your prescription medications (not right away anyway!). You are now using them as a crutch for your condition, and it would be foolish to think that the herbs are going to substitute for the medications. This type of thinking would be similar to thinking that just because you have new orthopedic boots you don’t need your wheelchair anymore.

Other herbs that might be helpful include metallic compounds like Suvarna-Bhasma, Abhrak-Bhasma and Shrung-Bhasma are used. These medicines are given in combination with herbal medicines which act on the heart muscle, such as Arjun (Terminalia arjuna), Guggulu (Commiphora mukul), Draksha (Vitis vinifera), Triphala (Three fruits), Amalaki (Emblica officinalis), Punarnava (Boerhaavia diffusa), Sarpagandha (Rauwolfia serpentina), Pippalimool (Piper longum), Chitrak (Plumbago zeylanica), Bhallatak (Semicarpus anacardium), Myrrh (Commiphora myrrha) and Pushkarmool (Inula racemosa). The above mentioned medicines also help to reduce high blood pressure and normalize heart and lung functioning. Once the symptoms are controlled, medicines like Bruhat-Vat-Chintamani, Shrung-Bhasma, Chandrakala-Ras and Kamdudha-Ras can be given on a long term basis to prevent recurrence of A-fib.

Avoid any stimulant herbs such as guaraná, ginseng, tongkat ali, yohimbe, kola nut, and yerba maté you may be using. In some individuals, marijuana use may induce A-fib.

Yoga and A-fib

Yoga may also be very useful in the treatment of Atrial Fibrillation. A study at the University of
Kansas Hospital found that regular yoga sessions (two one-hour sessions per week for three months plus yoga practice at home) lowered the number of atrial fibrillation episodes by nearly 45 percent in a group of 49 patients. Practicing yoga also improved quality of life, eased depression and decreased the anxiety reported by some of the study participants. Before beginning the yoga sessions, patients performed any exercise of their choice for three months, during which they continued to have nearly twice the number of atrial fibrillation palpitations they later had while practicing yoga. All of the patients were taking anticoagulant and anti-arrhythmic drugs. Because this study was small, had no control group and only a short duration of follow-up, the results are regarded as preliminary. But they do suggest that yoga can have a positive effect on atrial fibrillation, as well as on the anxiety and depression that affect some patients.

Specific postures that should benefit A-fb include Adho Mukha Svanasana (Downward Facing Dog) and Bidalasana (Cat-lift round pose). At times lying on one's back on the floor and raising the legs above the head and resting on a wall could help certain types of heart irregularities self-correct.

One should select a gentle style of yoga for this purpose, such as Iyengar, avoiding the more aggressive and demanding varieties such as power yoga, hot yoga, Bikram yoga and Ashtanga.

Pranayama and A-fib

If you have A-fib, some breathing exercises, or pranayama can be of particular benefit.

Ujjayi (Ocean-sounding breath): This will help slow down and control your breathing. Place your tongue behind your top teeth. Slightly tighten your throat muscles to slow the flow of air as much as possible while you breathe in and breathe out through your nose. You should hear it as it passes through.

Nadi Shodhana (Alternate nostril breathing): Think of this as a way to reset your breath. Follow these steps:
• Put your right thumb on your right nostril to block air as you breathe in through the left
• Then block the left nostril with your right ring finger as you remove your thumb and breathe out through the right nostril
• Keep the left closed while you breathe in through the right
• Close the right and exhale left
• Do 10 to 12 sets of two

Dirgha pranayama (Three-part breathing): Slow down your breathing like you do in the ujjayi method, and then focus on the three parts of your torso.

Lifestyle Practices

If you have any risk factors for heart disease, making an effort to lower them is important for your heart health in general, as well as for your atrial fibrillation. Reducing lifestyle risk factors such as being overweight, having high blood pressure, high cholesterol or high blood sugar levels, sleep breathing problems (such as sleep apnea), and smoking and drinking can help those with A-fib live longer.

• Limit caffeine, alcohol and tobacco, all of which can set off the abnormal heart rhythms, and avoid any drugs (over-the-counter) that speed your heart rate

• Get regular physical activity (this helps with stress reduction, weight loss, and is one of the most effective natural remedies for high blood pressure)

• Follow a protein-rich diet to ensure that you're getting enough magnesium and potassium, minerals that may prevent some arrhythmias

• Supplementation with magnesium taurate may be especially useful, along with an equal dose of calcium if needed, to offset magnesium's laxative effect. Fish oils (EFAs) and Vitamin C may also be very helpful, but be aware that many dietary supplements can stimulate heart tissue and would not be advised to those with this condition. Some of them include tyrosine, phenylalanine, SAM-e, and alpha lipoic acid. There are many others that act as stimulants, e.g., high doses of vitamin D could be a cause, so it is best to check with one’s health care provider before making any decisions as to which herbs to consume and which to avoid.

Article provided by William Courson, BVSA, Dpl. Ayur., C.H. an Ayurvedic Practitioner, faculty member and the College Dean of Institutional Development at Sai Ayurvedic College & Ayurvedic Wellness Center.

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