Atrial Fibrillation, Natural Treatment in Denver Area

NatureMed clinic is located in southeast Boulder. We are 20 minutes from Central Denver. We serve patienrs in the greater Denver area. Dr. Steve Parcell heads the integrative cardiology group there. NatureMed  integrates conventional, Western, allopathic medicine with holistic, naturopathic medicine using science based approaches that work.
 
Atrial fibrillation is the most common arrhythmia worldwide and is a significant risk factor for stroke and peripheral embolism (blood clot). It has negative effects on cardiac function. It typically starts after age 50 and is more common as people get older. It is more common in Caucasians than other races. Often it is fixable with naturopathic approaches. We monitor patients with ECG often using a holter monitor.

There are 3 main types of atrial fibrillation
·         Paroxysmal atrial fibrillation: Spontaneously starts and stops only lasts for a day or 2
·         Persistent atrial fibrillation last longer than a week with symptoms are stopped following cardio conversion
·         Long-standing persistent atrial fibrillation last longer than a year and the patient usually takes a rhythm control medication

Symptoms of atrial fibrillation
·         Fatigue
·         Palpitations
·         Shortness of breath
·         Lightheadedness
·         Dizziness
·         Chest pain or discomfort
·         Fainting

Conditions associated with increased chance of getting atrial fibrillation
·         High blood pressure
·         Coronary artery disease
·         Cardiomyopathy
·         Obesity
·         Sleep apnea
·         Heart valve problems
·         Diabetes
·         Hyperthyroidism
·         Pneumonia
·         Alcohol abuse

The goal of treatment
·         Prevent clots
·         Control heart rate
·         Restore and maintain regular rhythm as much as possible

Conventional treatment involves medication such as beta blockers and calcium channel blockers as well as anticoagulants such as Coumadin and Pradaxa. Electrical cardioversion helps restore normal heart rhythm and medication does not improve symptoms but does not always fix the problem. Patients often complain of side effects from the medications. Patients over the age of 70 with no coexisting disease may be candidates for ablation therapy. Occasionally very ill patients who are also older are sometimes candidates for ablation because the stroke risk is so high and they cannot tolerate the medications. The success rate of ablation worldwide is about 70% in patients who follow up with their doctor.

Antiarrhythmic medication side effects
·         slow heartbeat
·         fatigue
·         palpitations
·         dizziness
·         nausea
·         vomiting
·         stomach pain
·         constipation
·         diarrhea
·         skin rash
·         vision problems
·         urinary retention in men

Naturopathic perspective and considerations

Many patients are tired of “rat poison” (Coumadin) and medications that cause too many side effects such as fatigue and dizziness. Naturopathic treatment is individualized to the patient and may include:
·         Losing weight
·         Limiting alcohol
·         Limiting caffeine
·         Addressing magnesium deficiency with intravenous magnesium
·         Controlling stress
·         Preventing vitamin K deficiency in patients on Coumadin
·         Evaluating stroke risk with special blood tests not typically ordered by insurance based doctors
·         Use plant medicines such as Hawthorne extract
·         Use natural anticoagulants such as  nattokinase and lumbrokinase
·         Follow up with blood tests to ensure efficacy of blood thinning effect

Intravenous magnesium can be highly effective!
Magnesium regulates cellular enzymatic and metabolic processes throughout the body. In myocardial (heart muscle) cells, magnesium antagonizes (acts against) calcium and potassium channels. Magnesium has been shown to affect the transport of ions that regulate the cardiac muscle action potential. In addition, electrophysiologic studies have demonstrated slowed cardiac conduction and increased cardiac refractoriness with administration of magnesium. Magnesium has an accepted role in the management of ventricular arrhythmias, including torsade de pointes. Electrolyte imbalances may contribute to the development of atrial tachyarrhythmias (irregular fast heart beat) by causing abnormal impulse generation, which could initiate atrial fibrillation.

Electrophysiologic studies performed in humans with normal serum magnesium concentrations have demonstrated that time required to conduct an impulse through the atrial tissue and time of unresponsiveness to electrical stimuli are increased after administration of intravenous magnesium. This means that the heart muscle (myocardium) can become less sensitive to stimuli, including nervous system input.

Serum magnesium concentrations are often used to monitor magnesium status and to guide supplementation therapy. Unfortunately, magnesium measured in the serum represents only about 1% of the total body content of the electrolyte. Blood magnesium levels are NOT ACCURATE in assessing intracellular magnesium stores.

We like to analyze epithelial cells collected from a patient's oral mucosa. Measurement of intracellular magnesium levels in cells swabbed from the patient's mouth with use of a noninvasive test correlates well with intracellular magnesium levels obtained from atrial tissue samples of patients undergoing cardiac surgery.

Key points
·         Serum magnesium concentration is an imperfect measure of total-body magnesium content. Noninvasive measurement of intracellular magnesium concentrations provide added insight into the true role of total-body magnesium content in the etiology of atrial tachyarrhythmias. 
·         Intravenous magnesium is very effective in managing atrial fibrillation.
·         The amino acids, in addition to some botanical medicines can also be effective.
·         Diet and lifestyle modifications also help.
·         Some patients may not respond to naturopathic treatment and may need ablation. In our experience 80% of patients with atrial fibrillation get definitive improvement with our integrative, naturopathic approach at our Boulder office that treats the cause of A Fib.

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