A Naturopathic Perspective
Emily A. Kane, ND, LAc

There’s a saying among cardiologists that rate is easier to control than rhythm. One of the problems with arrhythmias is that the anti-arrhythmic drugs are typically rife with dangerous side effects. The best known, amiodorone, works by blocking sodium and potassium flux in cardiac muscle cells. Possible side effects include lung damage, hypothyroidism, cataracts and skin discoloration.1,2 Naturopathic therapy can be very effective for mild arrhythmias. This paper will focus primarily on what I have learned about atrial fibrillation (AFib) over the years, but first I will review a few other common arrhythmias. (See Figure 1 for an example of normal sinus rhythm.)

Premature Ventricular Contractions (PVCs)

Premature ventricular contractions (PVCs) are quite common, almost always completely benign and usually “treated” adequately with patient reassurance (Figure 2). Caffeine and other stimulants tend to worsen these hard, extra beats. Typically, with PVCs the cardiac rhythm does not deviate for long from sinus rhythm, but sometimes PVCs can be frequent enough and noticeable enough, particularly in a thin patient, to cause considerable consternation. When avoidance of stimulants, which besides caffeine might include bronchodilators, is insufficient to provide relief, ½ dropperfull (about 15 drops) of Cactus grandiflorus or Selenicereus grandiflorus, daily at the same time of day, can significantly ease the frequency and severity of PVCs. Patients with PVCs regularly request refills of Cactus, and stop pursuing other avenues of relief, which is perhaps not “proof” but certainly anecdotal evidence that the therapy works well. There exists literature support that deficiencies of taurine and L-arginine can cause PVCs, as well as atrial fibrillation and premature atrial contractions (PACs). In one study of people with very frequent arrhythmias, taking 10-20 g taurine daily prevented PVCs, but not pauses, in the sinus rhythm. Adding 4-6 g L-arginine terminated the pauses. Taurine is thought to dampen epinephrine release (sympathetic activity), and L-arginine, being a nitric oxide precursor, may help create the conditions for spontaneous cardioversion.3 As with all arrhythmias, rhythm disturbances may be a manifestation of early Graves’ disease, but this is not a common etiology.4

PVCs

In a 104-pound adult female patient, PVCs were controlled by Cactus for about a decade. At menopause, her PVCs become significantly worse and she was having up to 20 PVCs per minute, for hours at a time.5 Clearly this was an untenable situation for her, despite knowing they were “benign.” Estrogen therapy helped somewhat, but caused fibroids to grow. Her thyroid function was normal. Being thin made her more sensitive to both the PVCs and the fibroid pressure. She was referred to an electrophysiologist who found that she had an extraordinary amount of ectopic electrical tissue distributed throughout the heart, including deep in the septum, which separates the 2 ventricles. She received a total of 3 electrocautery reductions of ectopic tissue, which significantly helped reduce the PVCs. However, because of the widespread nature of her ectopic tissue and the tricky location in the septum, some ectopic tissue remains and she does occasionally suffer from a run of hard PVCs. I also discovered with this patient that cardiac tonics, such as Cretaegus oxyacantha (hawthorn), were contraindicated because they made the PVCs stronger. Her heart as a pump and vascular structure have no defects – her aerobic capacity is good. She, like most patients with PVCs, simply has an electrical problem.

Paroxysmal Supraventricular Tachycardia (PSVT)

Another fairly common arrhythmia is PSVT: paroxysmal supraventricular tachycardia (Figure 3). This is slightly more common in tall people, possibly exacerbated by the elongation of the cardiac muscle. Typically, during an episode the pulse will more than double and the person will begin to feel quite fatigued, as though they just ran a marathon. These episodes tend to come on with stress, but can also be provoked by stimulants. Valsalva maneuver can terminate an episode. Also, cold face dips may help to convert PSVT into sinus rhythm by triggering the “drowning reflex” (which, incidentally, can also help break an asthma attack). In both instances, the vagus nerve is activated and electrical conduction in the heart is slowed. Nitric oxide, a vasodilator, increases with amyl nitrate, nitroglycerine, or L-arginine, and may be helpful in breaking a run of PSVT, but I have found cold face dips to be just as helpful. Homeopathic glonoine can help stop PSVT, as can rest. After several hours of conservative therapeutic attempts to restore sinus rhythm, the patient may choose to go to the emergency room, where typically IM adenosine is given, which stops the heart for around 5 seconds and allows sinus rhythm to resume. Ultimately, the patient with chronic PSVT will do best with catheter ablation, where a wire is passed to the heart through a vein at the groin, and abnormal tissue is cauterized with electrical energy.6 This typically provides definitive relief. In my opinion, the risks of long-term anti-arrhythmic drug therapy is far riskier, and much less satisfactory, than ablation performed by a skilled electrophysiologist.

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