Operating under the control of a complex internal electrical system, the heart beats out a continual rhythm from a few weeks after conception until death. This rhythm is ordinarily even and regular, changing speed as necessary to adjust to the body’s need for oxygen.
Sometimes, however, the heart’s rhythm becomes disturbed (“arrhythmic”). The most common and benign form of arrhythmia is the common “heart palpitation,” known technically as sinus arrhythmia. Generally, these are felt as a short run of thumps or flutters in the chest. Sinus arrhythmia is often caused by stress and anxiety. It poses no danger, although it can be annoying.
More serious forms of heart arrhythmia may occur as well. In later life, many people develop atrial fibrillation, a condition in which part of the heart contracts at excessive speed and another part follows along irregularly. Although some people live for years in a state of atrial fibrillation, this is a potentially dangerous condition that requires medical attention.
Other forms of heart arrhythmia are more dangerous still, including ventricular tachycardia and ventricular fibrillation. These frequently occur after a heart attack. They are often heralded by ventricular premature complexes.
Conventional treatment for arrhythmia depends on the type involved. Sinus arrhythmias are often left untreated. More serious rhythm disturbances are addressed through the use of medications, defibrillation, or a pacemaker.
Note: Heart arrhythmias are far too dangerous for self-treatment. In all but the most obviously benign cases, medical supervision is mandatory.
Although the use of
fish oil to help prevent dangerous heart arrhythmias has received considerable research attention,1-2,15-17,20,22,23,24,25
the evidence for its effectiveness remains conflicted.
tends to stabilize the heart, and intravenous infusions of magnesium are sometimes given to people in cardiac intensive care. However, a 6-month,
double-blind, placebo-controlled study of 170 people did not find oral magnesium effective for maintaining normal heart rhythm in people with a tendency to develop atrial fibrillation.3
Diuretic drugs in the
family tend to deplete the body of the minerals potassium and magnesium. People using such drugs are usually advised to take
potassium supplements because potassium deficiency can cause arrhythmias. One small double-blind study failed to find that additional supplementation with magnesium further stabilized the heart.14
Apparently, the extent of magnesium deficiency caused by thiazide diuretics is not severe enough to destabilize the heart’s rhythm.
However, the drug
appears to sensitize the heart to magnesium deficiency. People with
congestive heart failure (CHF)
are likely to use both digoxin and loop diuretics (another type of diuretic that depletes magnesium), and the net result can be cardiac arrhythmias
5-8 One small double-blind, placebo-controlled study found that magnesium supplements reduced episodes of ventricular arrhythmia in people with CHF.4
A controlled study found preliminary evidence that vitamin C may help prevent one of the types of arrhythmia (atrial fibrillation) that can follow coronary artery bypass grafting.19
However, because this trial failed to include a placebo group, its results are suspect.
hawthorn is widely used to treat mild palpitations, but scientific evidence to show that it is effective consists only of partially relevant test-tube studies.9-13
N-acetyl cysteine (NAC), a modified version of a dietary amino acid, was shown in a pilot placebo-controlled study (115 subjects) to reduce the incidence of atrial fibrillation following open-heart surgery, a common complication of this kind of procedure.21
When palpitations are caused by
stress, herbs and supplements used for those conditions may be helpful. See the individual articles for more information.
Other herbs and supplements sometimes recommended for palpitations, but which have little supporting evidence, include
Preliminary evidence suggests that
acupuncture may help prevent abnormal heart rhythms in people with atrial fibrillation who have undergone cardioversion (an electrical shock is delivered to the heart to return it to a normal rhythm).26
Caffeine stimulates the heart and may cause minor palpitations. Herbs containing caffeine, such as
cola nut, would be expected to cause similar problems. The herb
also stimulates the heart and should be avoided by people with palpitations.
A few reports suggest that the supplement
creatine could, at times, cause heart arrhythmias.18
Numerous herbs and supplements may interact adversely with drugs used to prevent or treat arrhythmias. For more information on this potential risk, see the individual drug articles in the
section of this database.
Sellmayer A, Witzgall H, Lorenz RL, et al. Effects of dietary fish oil on ventricular premature complexes.
Am J Cardiol.
Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione.
Frick M, Darpo B, Ostergren J, et al. The effect of oral magnesium, alone or as an adjuvant to sotalol, after cardioversion in patients with persistent atrial fibrillation.
Eur Heart J.
Bashir Y, Sneddon JF, Staunton A, et al. Effects of long-term oral magnesium chloride replacement in congestive heart failure secondary to coronary artery disease.
Am J Cardiol.
Martin BJ, Milligan K. Diuretic-associated hypomagnesemia in the elderly.
Arch Intern Med.
Cohen L, Kitzes R. Magnesium sulfate and digitalis-toxic arrhythmias.
Toffaletti J. Electrolytes, divalent cations, and blood gases (magnesium).
Whang R, Oei TO, Watanabe A. Frequency of hypomagnesemia in hospitalized patients receiving digitalis.
Arch Intern Med.
Joseph G, Zhao Y, Klaus W. Pharmacologic profile of crataegus extract compared to epinephrine, amrinone, milrinone and digoxin in isolated guinea pig hearts [in German; English abstract].
Popping S, Rose H, Ionescu I, et al. Effect of a hawthorn extract on contraction and energy turnover of isolated rat cardiomyocytes.
Al Makdessi S, Sweidan H, Dietz K, et al. Protective effect of
against reperfusion arrhythmias after global no-flow ischemia in the rat heart.
Basic Res Cardiol.
Krzeminski T, Chatterjee SS. Ischemia and early reperfusion induced arrhythmias: beneficial effects of an extract of
Crataegus oxyacantha L.
Pharm Pharmacol Lett.
Kurcok A. Ischemia and reperfusion-induced cardiac injury: effects of two flavonoid containing plant extracts possessing radical scavenging properties [abstract].
Naunyn Schmiedebergs Arch Pharmacol.
Lumme JA, Jounela AJ. The effect of potassium and potassium plus magnesium supplementation on ventricular extrasystoles in mild hypertensives treated with hydrochlorothiazide.
Int J Cardiol. 1989;25:93-98.
Calo L, Bianconi L, Colivicchi F, et al. N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial.
J Am Coll Cardiol. 2005;45:1723-1728.
Geelen A, Brouwer IA, Schouten EG, et al. Effects of n-3 fatty acids from fish on premature ventricular complexes and heart rate in humans.
Am J Clin Nutr. 2005;81:416-420.
Raitt MH, Connor WE, Morris C, et al. Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial.
Kammer RT. Lone atrial fibrillation associated with creatine monohydrate supplementation.
Eslami M, Badkoubeh RS, Mousavi M, et al. Oral ascorbic acid in combination with beta-blockers is more effective than beta-blockers alone in the prevention of atrial fibrillation after coronary artery bypass grafting.
Tex Heart Inst J.
Jenkins DJ, Josse AR, Beyene J, et al. Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis.
Ozaydin M, Peker O, Erdogan D, et al. N-acetylcysteine for the prevention of postoperative atrial fibrillation: a prospective, randomized, placebo-controlled pilot study.
Eur Heart J.
2008 Feb 8 [Epub ahead of print].
Nodari S, Metra M, Milesi G, et al. The Role of n-3 PUFAs in preventing the arrhythmic risk in patients with idiopathic dilated cardiomyopathy.
Cardiovasc Drugs Ther.
2008 Nov 4.
Saravanan P, Bridgewater B, West AL, et al. Omega-3 fatty acid supplementation does not reduce risk of atrial fibrillation after coronary artery bypass surgery: a randomized, double-blind, placebo-controlled clinical trial.
Circ Arrhythm Electrophysiol.
2010 Feb 1;3(1):46.
Kowey PR, Reiffel JA, Ellenbogen KA, Naccarelli GV, Pratt CM. Efficacy and safety of prescription omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: a randomized controlled trial.
Liu T, Korantzopoulos P, Shehata M, Li G, Wang X, Kaul S. Prevention of atrial fibrillation with omega-3 fatty acids: a meta-analysis of randomised clinical trials.
Lomuscio A, Belletti S, Battezzati PM, Lombardi F. Efficacy of acupuncture in preventing atrial fibrillation recurrences after electrical cardioversion.
J Cardiovasc Electrophysiol.
Last reviewed August 2013 by EBSCO CAM Review Board
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