Published February 25, 2009 in the North Island Weekender 

In my practice I am seeing more and more cases of atrial fibrillation known as Afib and particularly in younger populations of men and in women over the age of 60. I am wondering why this perceived increase in incidence?

There can be many causes of atrial fibrillation (AF), the most common form of sustained heart arrhythmia, where the electrical signal to the atrial chambers of the heart becomes irregular causing disorganized and rapid contractions of the atria. The frequency may be paroxysmal or chronic. AF results in ineffective pumping of blood through the body causing fast heart rate, chest pain, shortness of breath, fatigue, dizziness and faintness.

The incidence is higher in men than women across all age groups. Men aged 55 years old have a 25 % risk of developing afib during their lifetimes. The average lifetime risk for a 55-year-old woman was found to be 23%.  About a quarter of the population between the ages of 55 and 75 years can expect to develop AF at some point in their lives – a sobering thought indeed!

Some of the common drugs used to treat AF include digoxin and amiodarone. Digoxin is often given to patients after coronary bypass surgery and some studies showed that digoxin increased the incidence of AF after surgery. Amiodarone, a form of iodine, is another very strong drug that has many side effects. The drug that is most often prescribed is warfarin, a blood thinner. This is to prevent the formation of a blood clot that can form when the heart is fibrillating. Naturopathic treatments are used in combination with warfarin and monitored using INR blood tests.

Causes can include alcohol, physical or emotional stress, stimulant medications, heart surgery or heart attack, inflammation of the sac around the heart, overactive thyroid, blood clot of the lung, high blood pressure, coronary heart disease and diseases of the heart valves or heart muscle. For some there is no apparent cause or underlying disease. It is these patients that I am most curious about. What could be some underlying causes that conventional medicine is not looking at?

Dr. Matthias Rath, MD, a leading American expert on cardiovascular disease, believes that arrhythmias are primarily caused by nutritional deficiencies and can be prevented by optimizing the intake of such nutrients as vitamin-C, coenzyme Q10, magnesium and vitamin B complex. Magnesium is of particular importance as it is highly concentrated in the heart muscle and counteracts excessive calcium, which tends to excite the heart. Dr. Abram Hoffer, MD reports excellent results in the prevention of AF through the use of mega-doses of niacin and folic acid. Other researchers are looking at the impact of mercury toxicity on heart health, citing an increase incidence of heart attack.  Some patients find that avoiding food allergies or treating their gastric reflux makes a difference.

The naturopathic approach to AF includes the following supplementions:

 1.    Fish oil: It has been shown consistently in the research that fish oil increases fibrinolytic activity(breaking down fibrin that contributes to clots) and decreases the viscosity of the blood. Large doses are required to keep INR’s in the target range of 2-3. Fish oil also have a strong affect on the conduction in the heart and acts as an anti-arrhythmic. It reduces the incidence of sudden death in survivors of heart attacks and ventricular tachycardia (a fatal arrhythmia).

 2.    Magnesium: Low magnesium levels has been associated with an increased risk of arrhythmias. When administered intravenously to those who are in active AF is 84% effective. It is always administered orally as well in the glycinate form at bowel tolerance dosages for best results. Certain diuretics deplete magnesium and magnesium is one of the most common mineral deficiencies in North America due to poor diet.

 3.    Herbal remedies: Many botanicals have anti-arrhythmic properties including hawthorn (widely used in Europe for arrhythmias) and convallaria and others prevent clot formation. Naturopathic physicians will prescribe a combination of herbs as indicated.

 4.    B vitamins are also a common North American deficiency that can lead to heart disease.

 5.    Vitamin E: Prevents platelets from sticking together to form a clot and protects against mercury toxicity.

 6.    Selenium is a mineral that also protects against mercury toxicity.

 7.    Vitamin C is a strong anti-oxidant alleviating oxidative and inflammatory stress after bypass heart surgery.

 8.    CoQ10: is an anti-oxidant widely used in Japan for its anti-arrhythmic effect. This important anti-oxidant and free radical scavenger stabilizes cell membranes. It is greatly depleted by all statin drugs.

 9.    Rule out food allergies and gastric reflux as a cause.

10.    Monitor and detoxify mercury and other heavy metals as possible risk factors.

Although an acute atrial fibrillation attack is very frightening it is rarely life threatening. Several recent studies have concluded that the mortality rate among people who have intermittent atrial fibrillation attacks, but no underlying heart disease, is no greater than that of the general population. Perhaps AF can be prevented if some of the above deficiencies were addressed routinely in the aging population.