Herbals for the Heart

Herbals for the Heart

It is hard to kill people. Humans have great physiologic reserve and the ability to tolerate, at least for a short period time, remarkable extremes. I spend most of my time in acute care hospital medicine and have seen many examples of wildly deranged physiology and horrific trauma that with support and treatment the patient recovered.

Still, there are some organs that are not quite as forgiving and I am always leery to mess with the cardiac conduction system, the electrical system of the heart. Ventricular fibrillation, aka sudden death, is not a forgiving medical condition. When I was a resident the goal with heart attack patients was to suppress every aberrant beat, premature ventricular contractions (PVC’s), as it was thought they were the sentinel event for fibrillation. Nope. Turned out that suppressing all those PVC’s was a bad idea and that some of the antiarrhythmics killed more people than they saved. These days people are more likely to get an implanted defibrillator than be put on antiarrhythmics drugs.

Still, there are a variety of cardiac arrhythmias that plague people and can be difficult to treat.

Given how important the heart is to maintaining life, I was surprised to find there are a variety of complementary and alternative medical treatments for arrhythmias.  In the link they review 6 herbal products, acupuncture and yoga.

The herbal products are barberry, cinchona, hawthorn, khella, motherwort, omega–3 PUFA and Wenxin Keli and most do have some antiarrhythmic activity. Some, like chichona, are the origin of modern antiarrhythmics. They all have important drug-drug interactions.

The scary aspect of these herbals is they could potentially really affect the conduction system and, as we learned with real medications, the effects are not always beneficial. Patients tend not to report herbal use and doctors often do not ask if patients are on them.

As one review concluded

clinical studies are lacking to support routine use of these herbal medications. In addition, some herbal supplements may cause serious proarrhythmia, and many supplements significantly interact with warfarin and digoxin.

I usually consider herbs, like the Earth, to be mostly harmless. In the case of these products I would be more concerned.

And acupuncture?

They say

Although plagued by methodological shortcomings, these studies support acupuncture as an effective treatment for AF, paroxysmal supraventricular tachycardia, inappropriate sinus tachycardia, and symptomatic premature ventricular contractions.

“Plagued by methodological shortcomings” is quite the understatement and what data I can find there suggests nothing of sort. Lousy studies do not support acupuncture as effective.   I would be skeptical that putting a needle in the arm would have any significant cardiac effects.

The heart is best left alone by amateurs and herbalists.  


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Points of Interest: 4/24/2014