Diagnose Atrial Fibrillation with Chinese medicine

two human hands painting

Key Points

1/ How does Western Medicine diagnose Atrial Fibrillation (AF) and then deal with it?

2/ How Chinese medicine diagnoses AF.

3/ How Chinese medicine treats Atrial Fibrillation.

4/ Which diets and supplements may help it.

How to Diagnose Atrial Fibrillation with TCM Chinese medicine

First, what is atrial fibrillation?

When your heartbeat suddenly races ahead, or your heart feels as if it’s racing or pounding or fluttering, or beating unevenly, together with you feeling tired or weak, possibly dizzy or faint and probably out of breath, then you can probably diagnose atrial fibrillation.

[By the way, this is not exactly the same as what Chinese medicine calls ‘palpitations’ which is when you have a subjective feeling in your chest that your heart is beating in an uncomfortable way. In Chinese medicine, ‘palpitations’ does not necessarily mean atrial fibrillation.]

How would you be tested for this? Probably your doctor would order an ECG, (electrocardiogram), which measures how your heart is beating, showing any irregularity

Why does your doctor worry about this? Because if your heart isn’t pumping your blood round smoothly, eddies of blood may build up which could solidify into clots.

If such clots get dislodged, they may then head off towards your brain or the arteries feeding your heart. With the former you get a stroke, in the latter a heart attack – myocardial infarction.

What are the causes of AF?

In Western medicine, the cause is unknown. However, it often occurs in people with other heart conditions such as:

  • Atherosclerosis, when arteries clog up with fat
  • Cardiomyopathy, when heart muscle stretches or thickens
  • Congenital heart disease ie present from birth, possibly inherited
  • Heart surgery recently
  • Heart valve abnormality or disease
  • High Blood pressure (ie hypertension)
  • Lung disease – chronic
  • Pericarditis, inflammation of the area round the heart
  • Previous heart attacks or heart failure
  • Serious infections

 

Atrial Fibrillation is associated with other medical conditions, like:

assorted medication tables and capsules
Atrial fibrillation often occurs when there’s a background of other chronic illness.
  • Asthma ie a chronic condition with difficulty breathing
  • Carbon monoxide poisoning
  • COPD – chronic obstructive pulmonary disease
  • Diabetes, type 2
  • Lung Cancer
  • Pneumonia – inflamed, swollen lung tissue, often from a bacteria
  • Pulmonary embolism – a blood vessel in your lungs getting blocked
  • Sleep apnoea – when you stop breathing for a while when asleep
  • Thyroid gland overactive

 

Western medicine does recognise various possible triggers for AF, like:

  • Alcohol – drinking too much eg binge-drinking
  • Caffeine in excess (eg cola, coffee, tea)
  • Drugs – illegal – overuse, especially of stimulant drugs
  • Obesity or being overweight
  • Smoking

 

How you might diagnose Atrial Fibrillation

Take your pulse!

‘Normal’ pulse rates depend on age (more on this below) and vary between 90 beats per minute in young children to 68 in people over 50.

If your normal pulse (taken when resting and not ill, and when not having had caffeine or other stimulants, and not smoking) far exceeds say 100bpm, ask your doctor to arrange for you to have an electrocardiogram – ECG.

Other tests include an echocardiogram which measures the structure and function of your heart and its valves, or a chest X-ray, and probably further blood tests to reveal any anaemia or thyroid gland overactivity.

 

Western medicine treatment for Atrial Fibrillation

How does Western medicine diagnose atrial fibrillation?
See your doctor for a diagnosis!

Once they diagnose atrial fibrillation, the aim is to regulate your heartbeat and reduce the risk of stroke or heart attack from blood clots released into your arteries.

Various factors influence what kind of treatment you’ll get: your age, general health, symptoms, the kind of AF you have and any underlying health problems, such as an overactive thyroid gland.

There are three main approaches to atrial fibrillation in Western medicine.

Crazy Fast Heartbeat

If your heartbeat is beating crazily fast, ie well over 100bpm – such as 150 or 200bpm –  out of control, with symptoms as above, then electrical stimulus is applied to shock it back to a more normal rhythm. If not so acute, there are medicines to restore the normal heart rhythm, like flecainide.

Faster than normal with AF symptoms

If your normal heartbeat is a bit fast and occasionally races, especially if this happens when you are tense, then your doctor might also diagnose atrial fibrillation and prescribe beta blockers which calm and steady you and your heart. (But they wouldn’t normally do this if your heartbeat were slow.)

Other options include calcium channel blockers like verapamil or diltiazem.

They may also suggest anti-coagulants – see below.

Slow heartbeat with other AF symptoms

If your normal heartbeat is slow, but occasionally shows atrial fibrillation, then blood is pumping only slowly around anyway, and eddies may well produce clots which might cause a stroke or heart attack. So here your doctor almost certainly wants an ECG (electrocardiogram) to diagnose atrial fibrillation and then prefers something to ‘thin’ your blood, to stop it clotting.

In the past they gave you warfarin or possibly aspirin, but now they probably prefer drugs like Apixaban, also known as Eliquis.

Of course, your doctor will be extra-cautious if you or your family has a history of bleeding, or if you’ve just had surgery, because Apixaban and similar drugs are anti-coagulants which might increase the likelihood of internal bleeding. (Which sounds, and is serious, of course, but easier to deal with than if you’re dead from a stroke! Besides, all medications have some side-effects and knowing about them beforehand lets you and your doctor take appropriate care.)

Of course, if there are other health problems, they would treat them too. For example if you have high blood pressure or diabetes or other heart disease.

All medications have side-effects. Read our page on Primary and Secondary Actions for more on the theory behind this.

How does Chinese medicine diagnose atrial fibrillation?

Pulse Taking on Left Wrist
Pulse Taking on Left Wrist

Before deciding on treatment, Traditional Chinese medicine (CM) diagnoses your condition into what are called syndromes. The experience of CM is that treating these syndromes correctly will improve if not eradicate the underlying reason for your atrial fibrillation. So it’s important to get it right! As explained, they don’t actually diagnose atrial fibrillation as such, but the underlying syndromes for it.

Foremost in identifying your syndrome is diagnosis according to yin and yang theory.

This may seem ridiculously esoteric, but bear with me and you’ll see why it helps. Let’s take those three main possibilities mentioned above. (In CM there are other possibilities explaining AF, some of which I describe further on below.)

Heartbeat is very fast.

Although the pulse quality, assessed by a skilled practitioner, would expose much more (for example, is the pulse ‘floating’ or ‘deep’ or ‘full’?) almost certainly a very fast heartbeat would be classified as a ‘rapid’ pulse.

That means there is either excess yang or deficient yin because either of these can produce rapidity.

With excess yang, it would probably be either a ‘full’ or an ‘overflowing’ pulse. (The other possibility is that it is a ‘leather’ pulse, tight and hard at the upper or superficial level, like the stretched surface of a drum, but empty when you press further. This underlying emptiness indicates, not excess yang which it may at first seem like, but severe yin deficiency.)

Yang symptoms are heating and moving, so this explains the Western medical approach of ‘shocking’ the system with a very high heartbeat to slow it down. (It’s a bit like a slap on the face of someone having hysterics, to bring them to their senses. Since I expect that sentence is politically incorrect somewhere, obviously you didn’t read it here.)

Dare I say it, but from the Chinese medical perspective, an electric shock is a rather blunt instrument!

Let us suppose that, for argument’s sake, the pulse is either full or overflowing, as well as rapid. This indicates it is an ‘excess’ pattern, (not a ‘deficient’ pattern, which would obtain if the pulse was a ‘leather’-type pulse).

(For more on the important difference between excess and deficient conditions, please see our page Excess or Deficient.)

What kind of Excess pattern?

So now, with Chinese medicine, we need to know what kind of excess pattern we’re dealing with. There are quite a few possibilities and here are just a few of them:

man in yellow shirt and brown pants using smartphone. Candidate for atrial fibrillation?
Potential client for Heart problems?

Each of these (and other possibilities, not listed) requires a different treatment, whether using acupuncture or herbs.

Treating Heart Fire

For Heart Fire, treatment would be to drain Fire and calm the mind. Calming the mind also means what you might call Counselling, because strong emotional patterns lead to Qi stagnation: initially Liver Qi stagnation, but this can easily ‘transmit’ to the Heart causing Heart Qi stagnation and excess yang, being Fire.  

If you ask ‘Can Anxiety Cause Atrial Fibrillation?’ – well, yes, it certainly can, if extreme and prolonged!

[So if you’re not used to the words used in Chinese medicine, that’s a quick introduction: words like “qi, stagnation, Fire”!

I think words like this are intuitively easier to understand than many of the words used by Western medicine to explain what’s going on.

After all, you probably know what stagnation means if you’ve ever been constipated or stuck in a traffic jam! Fire means something hot, burning though read more about it under Fire. For probably the most important word used in Chinese medicine, click on Qi.!]

Treating Heart Phlegm Fire

Treatment for the second, Heart Phlegm Fire, not only drains Fire but also, importantly, helps the body resolve or clear phlegm. That phlegm causes confused sometimes manic behaviour and thinking. (This syndrome may also need counselling because emotions can make Qi stagnate and over time, stagnating Qi can lead to Fire.)

To my mind, people with Heart Phlegm Fire have a worse condition than simple Heart Fire, because of the confusion they experience. Also, advise the Heart Phlegm Fire patient to avoid foods that increase phlegm such as dairy foods, and hot, greasy and spicy foods.

Treating Heart Qi Stagnation

Treatment for Heart Qi stagnation aims to get Heart Qi moving, because the danger is that if Heart Qi stagnates, not only may excess yang develop, such as Fire – see above – but Heart Blood may stop moving (from Qi stagnation you can get Blood stasis), which would be more serious (eg myocardial infarction and stroke). Where Qi stagnates, the patient may need counselling because, again,  emotional stress is a frequent cause of Qi stagnation.

In each of these above three syndromes causing a fast heartbeat you’ll see that calming the mind is important, which means both counselling and diet play a part. (Diet? Because what we eat plays such a major role in both physical and mental health.  J Clin Invest, 2011; 121: 3094-9 and Carpenter S. ‘That gut feeling’. American Psychological Association, 2012; 43: 50)

What acupuncture points would you use for such Heart syndromes?

Heart 7 Point
Heart 7 Point – Copyright Acupuncture-points.org

This depends on which syndrome you diagnose. Probably points to clear Heart Fire such as Heart 8 and 9, to calm the mind like Heart 7, to clear Heat, such as Large Intestine 11, possibly Du 12 or 14, and points to support Yin, such as Spleen 6 (tonified).

For phlegm-fire add Pericardium 5 and stomach 40, which resolve phlegm. Spleen 6 here would be reduced.

For Qi stagnation, mostly different points would be used, such as Liver 3, Pericardium 6, Heart 5, Ren 15 and points to ‘open’ the chest such as Lung 7 and Stomach 40.

In each of these three syndromes, the herbal formula would be different – quite different.

What if your heartbeat occasionally races and is normally a little fast?

Pulse qualities would again expose if this was due to underlying yin deficiency (eg a leather pulse) but otherwise this would again be a rapid pulse, albeit not as serious – probably – as the crazy fast heartbeat mentioned above.

If so, the Chinese medical treatment would be the same as for the crazy fast heartbeat, but, since it is less serious (probably) there would be more time to ‘re-educate’ the patient as regards emotional issues – via counselling perhaps – and foods.

Yes!! What you Eat affects your Health and possibly Atrial Fibrillation!

With a faster than normal pulse, the patient should avoid heating (yang-type) food and eat more (yin-type) cooling food. Please note! I’m not saying that eating the right foods would cure you – just that it will help!

Of course, it’s easy to tell someone what to eat or avoid, but as we all know (well, speaking personally anyway) changing your diet is actually quite difficult.

The trouble is, I like the foods that I know perfectly well are bad for me! And I’m in the very comfortable habit of taking them regularly, such as a mid-morning coffee with sugar. Yes, I don’t recommend it to patients, but you live just once! Also, read on for why it actually helps ME, but may worsen YOU.

As regards, the emotional issues, there are many acupuncture points to help calm and steady thinking, but Beta blockers do it too. So here it comes down to whether the patient can tolerate the possible side-effects of Beta blockers.

By the way, most of those Beta blocker side-effects, you will notice – if you clicked the link – are yin in effect: they slow you and your metabolism down, so you get yin-like symptoms, such as cold hands and feet, low blood pressure, weight gain and fatigue. Don’t blame your doctor or the drug! It’s doing precisely what it’s supposed to do, which is to counteract the excess yang you started with.

More Bad News on Beta Blockers for Atrial Fibrillation

Beta blockers for atrial fibrillation?

Further bad news about beta-blockers comes from research at New York University School of Medicine.

They followed 40,000 heart-disease patients over at least three years. According to their research, people on beta-blockers are “just as likely as those not taking the drugs to have a second heart attack or stroke”.

In fact, in those with heart-disease risk factors, there were more heart disease-related deaths when taking beta-blockers!” WDDTY 29 Jan 2015)

However, with good treatment from Chinese medicine, you won’t get such side-effects! (– that’s a small plug for what I do, by the way.)

Jonathan Brand colours

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Slow heartbeat with occasional atrial fibrillation

This is quite different, and in a way, potentially just as serious as the other two possibilities explained above. Why? Because it’s not so obvious. This is one candidate for explaining how some people just suddenly die, without apparent symptoms beforehand.

Now, almost certainly, had they been carefully questioned beforehand their doctor would have diagnosed AF. But the patient thought little of the problems he (or she, of course) experienced, or thought they were just due to ageing so … no point seeing the doctor.

Here we have a slower than normal heartbeat.

First, what is slow? Hard to say, because the rate of an average ‘normal’ heartbeat does change throughout life. When you’re 3 years old, your ‘normal’ pulse may charge along, full of health, at 90 beats per minute (bpm). Even going at 90 bpm, there’s nothing wrong with you! – when you’re aged three!

By the time you’ve reached your fifties or later, it may be less than 70 bpm, possibly quite a bit less than 70, say a rate in the mid-60s bpm, whereas between ages 30 and 50 it’s probably normal at around 72 bpm or so.

So by slow heartbeat I mean considerably slower than normal for your age. Maybe 55bpm when you’re in your sixties, for example. (All these bpm rates assume you’re resting and disease-free, of course.)

A Slow heartbeat in Chinese medicine

 

 

Ephemeral nature of fibrillation.
Beating too slow?

55 beats per minute, described in Chinese medicine, would be a ‘slow’ heartbeat. Since this is definitely an internal condition, I would expect your pulse also to be ‘deep’.

(‘Internal’? –  you ask! See our page on the eight principles.)

It might also be a ‘fine’ or thin pulse. In addition it could be classified as ‘firm’ or ‘weak’. It might also be ‘knotted’. Each of these descriptions suggests a different underlying condition.

Different Kinds of Slow Heartbeat in Chinese medicine.

For example:

  • Fine usually denotes Blood deficiency: or could be qi deficiency and damp.
  • Firm suggests Blood stasis or possibly Cold.
  • Weak suggests either yang deficiency and/or Blood deficiency.
  • Knotted (when the pulse is slow and stops at irregular intervals) means Cold and Heart Yang deficiency.
  • Hasty (when the pulse is Rapid but occasionally stops, irregularly) means severe Heat or Heart fire, but also Heart Qi deficiency.
  • Intermittent (the pulse seems to stop but at regular intervals) means Yin organ problems – often of the heart organ.

 

Of these, a slow, firm’ and knotted heartbeat is probably the most serious because they all suggest yang deficiency, but also ‘firm’ suggests impending Blood stasis.

Not far behind in potential severity is the hasty pulse because, as one may imagine, the Heat dries out the blood, leading to blood clots which, with Heart qi deficiency means blood doesn’t flow smoothly. This is ideal, unfortunately for blood clots to be nudged loose.

Blood stasis is bad news. That’s when a clot may form, unknown to anyone, and then one day it slips its moorings and heads off to block a blood vessel in the heart or brain. Then what? Over you keel – finish! (Unless you’re close to medical emergency help.)

How to deal with Clotting in Atrial Fibrillation

For this condition, Western medicine prescribes anti-coagulants to prevent clotting.

It used to be warfarin or a daily aspirin, but both can lead to internal bleeding, for example in your stomach or intestines. That internal bleeding might lead to blood deficiency and anaemia. (Aspirin and other NSAIDs may actually increase the likelihood of atrial fibrillation according to Danish research: BMJ, 2011; 343; doi: 10.1136/bmj.d3450)

Taking the Chinese medicine approach, such blood deficiency is also bad news because it’s like a riverbed in a drought: there’s no water, so nothing flows, so your get blood stasis. Again. Blood that has been thinned, such as with aspirin, may – from the Chinese perspective – be equivalent to Blood deficiency, a syndrome that can lead to atrial fibrillation, like when a speedboat’s propeller races when it leaves the water.)

Nowadays, the (Western medicine) medications of choice are anticoagulants or antiplatelets. For example Apixaban and Rivaroxaban.

How does Chinese medicine approach clotting in Atrial Fibrillation?

butterflies collection: first catch your patient!
First, catch your client (butterfly).

(Well, of course, first catch your patient! He or she doesn’t know he’s in any danger so why should he see you? Answer – education, which Western medicine is also enthusiastic about.)

Looking at the above possible syndromes you can see they are all deficient in nature (blood deficiency, yang deficiency, also qi deficiency) or full (Blood stasis) caused by yin factors such as cold, phlegm, or damp.

Let’s look briefly at each of these, but for more, please realise we have separate pages on them – click on the links to read them.

Also, important! Whereas Western medicine doesn’t know what causes AF, if you read the syndrome pages linked below, you’ll realise that often Chinese medicine can point more precisely to likely reasons behind it.

Various syndromes for a Slow Pulse and Atrial Fibrillation

Blood deficiency

There are several kinds of Blood deficiency. Good questions differentiate between them. For example, Heart Blood deficiency, Liver Blood deficiency, Heart and Spleen blood deficiency. Each has different underlying reasons, but all share a possible background of poor nutrition – eating habitually the wrong foods for health – and/or poor digestion. There’s more about nutrition for this, below. Blood deficiency can be an important cause if you diagnose atrial fibrillation.

Some possible syndromes

  • Yang deficiency: a big subject, about which I’ve even written a book. The main syndrome here is Heart Yang deficiency which has two main causes, one being over-exertion (usually physical), the other being Cold. On the Heart Yang deficiency page I’ve put suggestions for treatment and supplements to consider. You should avoid cooling or cold foods because they further weaken your yang energy, whereas eating more warming-type foods helps.
  • Qi deficiency. If you’ve got yang deficiency you almost certainly have some qi deficiency too. Read the linked page for suggestions.
  • Blood stasis. Please read the linked page on Blood stasis – there’s too much there to repeat here. There are many ways to get Blood stasis, including Blood deficiency (see links to various kinds above), yang deficiency, qi deficiency and qi stagnation. You can also acquire it from scarring, from surgery, from trauma, from physical overstrain, from haemorrhage, even from Heat. (How – from Heat? Because Heat dries and ‘steams’ blood, so thickening it. Thicker blood congeals more easily, forming clots.) And, most certainly, from Cold, (which retards motion, leading to congealing and blood clots)!
  • Cold is a major retarding influence on yang. It slows and stills, tightens and can kill.
  • Damp also retards Qi, just as thick fog slows traffic. So, as in fog, you get a few fanatics recklessly driving too fast, endangering everyone, so even in Damp you can get sudden Heart speediness, like AF.
  • Phlegm is a bit like Damp, but worse! With Heart Fire it can lead to manic behaviour and/or very confused thinking.

 

Helping Yourself if you diagnose atrial fibrillation but a have SLOW heartbeat normally

Self-help if you diagnose atrial fibrillation

What can you do to help yourself if you have signs of yang deficiency tending towards Blood stasis? And assuming, for the moment, you don’t want to take medication prescribed by your doctor?

  • Familiarise yourself with the pages linked above: in particular those on yang deficiency, qi deficiency, cold and damp. I’m sorry there are so many of them, but the strength of Chinese medicine is that it goes into all this quite thoroughly and – I hope – you’ll benefit from the information. Then read the pages on Warming foods (to eat more of) and Cooling Foods (to avoid).
  • Get some treatment from an experienced practitioner: acupuncture and/or Chinese herbs. Subject to a proper diagnosis and differentiation of syndromes, the aim is, broadly, to strengthen yang and move blood. However, before you take yang-strengthening herbs make sure you have no remaining pathogenic factor lurking within – another page to read, I’m afraid. (Also, this advice is not for you if you already have excess yang, causing a fast pulse. In that case, as explained above, you’d need different treatment to reduce yang excess first.)
  • More on warming foods and avoiding cooling foods. Avoiding cooling foods can sometimes mean that (uncooked) salads are ok, unless you are feeling tired or cold when eating them, and assuming you chew them well before swallowing. Ideally, you’d have something warm with them.
  • Take exercise, enough – regularly – to get you out of breath for 20 minutes at a time. And/or, several times daily, do the nitric oxide dump. This both thins your blood and strengthens your circulation.

 

The Elephant in the Room! Yin Deficiency

Many of the situations mentioned above happen because of excess yang. However, any excess yang situation eventually leads to yin deficiency too: the heat is generated from fuel which eventually runs out – nothing left to weigh it down or retard it. Like fuel forming ballast in a hot air balloon, when the fuel runs out the balloon rises too fast ie yang exceeds yin and your pulse quickens. Yin deficiency includes Blood deficiency.

You can then arrive at something like the syndrome ‘Heart Yin Deficiency with Empty Heat’. Here quelling the Fire will help only a little. What you must do here, and in other yin deficiency syndromes, is strengthen Yin.

How? It’s a big subject. One of the most popular pages on this site is on Yin Deficiency and I’ve even written a book about that, too (Yin Deficiency – Burnout and Exhaustion: What to Do!)– well received, even if a lot of it is common sense, once you understand the concept.

Here are a few suggestions on the subject. None of them will suit everybody but don’t dismiss them outright. Making just one small change, such as suggested, might save your life!

Easy Changes for most people with atrial fibrillation

clear drinking glass with water; may help with underlying reasons for atrial fibrillation

  • Drink more water! Water dilutes things, including blood that is thinking of clotting. Water may also benefit your blood pressure, normalising the difference between your systolic and diastolic pressures, and sometimes helping to reduce high blood pressure. However, a warning: too much water can dissipate your Yang energy too because your Yang energy is what metabolises water. At school, I often went on long runs (well, 5 – 10 miles, so not THAT long, but still) with other boys (single sex school at that time) and none of us ever carried water to drink. Nowadays it is rare to see a runner who is not carrying drinking water! Probably many runners now drink too much water. Having warned you about that, read ‘Your Body’s Many Cries for Water’ by F. Batmanghelidj. And now, research supports this ancient advice – see European Heart Journal, 2022; doi: 10.1093/eurheartj/ehac138. (However, that’s not quite the end of it because, as said, too much water may weaken your Kidney Yang qi, so your acupuncturist or herbalist should support this while you increase water intake. Also, you can help yourself by diluting food you eat, eating more fruit, and cooking in such a way that the food  you eat contains more water which your digestion can easily absorb – example: clogstoun congee. As I’ve remarked before, Chinese medicine has thought about all this quite carefully.)
  • Take life more slowly. If you diagnose atrial fibrillation, leave time for leisure, rest and sleep. Learn to enjoy life without always being productive. (I’ve found this piece of advice very hard to adopt.)
  • Do less mental work, and more easy, comfortable exercise, like walking. Exercise provides powerful protective effects against many diseases, including cardiovascular disease, diabetes and cancer. (Zugel, Maganaris & Wilke Br J Sports Med.52:1497) The benefits of exercise augment over time.
  • Take up gardening. The gardening I mean is neither horticulture nor redesigning then physically re-engineering your whole garden and patio, but pottering gently around with earth under your fingernails, planting, watering, weeding and pruning. Even window ledges qualify! But not heavy lifting.

 

General advice for anyone withe Atrial Fibrillation

Don’t Smoke

Smokers have twice the risk of Atrial Fibrillation compared to non-smokers. (Heart Rhythm, 2011; 8: 1160–6)

Alcohol

Even a little alcohol increases your risk of atrial fibrillation! (Eur Heart J, 2021 Jan 13; ehaa953 and Arch Intern Med, 2004; 164: 1993-8)

Aspartame and MSG may cause atrial fibrillation

Avoid! One doctor resolved his AF when he removed all artificial sweeteners from his diet. The AF returned when he re-introduced them to his diet! Also, see the site www.afibbers.org.

Painkillers and Atrial Fibrillation

I’ve already mentioned aspirin, but this and other painkillers such as NSAIDs (non-steroidal anti-inflammatory drugs) have produced huge increases in the incidence of AF.

Aspirin - not a good choice as a painkiller if you have atrial fibrillation.
NSAIDs are not good for atrial fibrillation.

While NSAIDs inhibit inflammation, some activate your blood clotting system, which can make blood clots more likely (apparently up to 70% more likely with COX-2 inhibitors – BMJ, 2011; 343: d3450)

Fats, fatty acids, oils and Atrial Fibrillation

I wish I could give you a definitive answer on the proportion of omega 3 and omega 6 fats you should eat – because you need both. Scientific metadata conclusions (ie when they look at lots of research conducted by different researchers over the years) are not firm one way or the other.

Saturated fats were, until recently, thought to be all bad, increasing cholesterol, which increased LDL, which caused heart disease.

But actually people with low cholesterol are more likely to die of heart disease! (http://www.garytaubes.com/wp-content/uploads/2011/08/Science-The-soft-science-of-dietary-fat.pdf)

My current opinion on the matter is that too much omega 6 in your diet contributes to higher inflammation, a factor in many chronic diseases, including high blood pressure and obesity both of which are underlying factors in AF. The heat from inflammation of course predisposes your blood to clot.

Which seeds contain omega-6 linoleic fatty acids? Examples are sunflower, safflower, soybean and canola.

The last two, with walnuts, also contain Omega 3 oils (alpha-linolenic acid) which you get from oily fish (also from flaxseed,  chia and hemp but the omega 3 fats from oily fish are the most easily absorbed) which are generally recognised as being beneficial for your heart.

Saturated fats were, until recently, thought to be all bad, increasing cholesterol which increased LDL which caused heart disease. But actually, people with low cholesterol are more likely to die of heart disease! (Adv Exp Med Biol, 1978; 109: 317–30)

“Inflammatory processes are likely to be involved in coronary heart disease.” (https://www.bmj.com/content/321/7255/199)

Omega 6 oils easily oxidise into oxidized linoleic acid metabolites (OXLAMS) which are inflammatory and exacerbate many forms of ill-health, including chronic pain, and cardiovascular disease, unlike omega 3 fats. (Urol Oncol, 2005; 23: 36-48, also Arch Neurol, 2003; 60: 940-6)

See also https://www.wddty.com/features/the-best-fats-for-a-healthy-brain/  1st Feb 2019.

Sugar and atrial fibrillation

Increasing evidence implicates sugar as a major source and cause of unwelcome fats in our bodies, periodontitis (unhealthy gum inflammation), diabetes and heart attack. (Diabetes Care, 2019; dc190018; doi: 10.2337/dc19-0018)

Sugar! Public health energy number 1?
Sugar – definitely not if you have atrial fibrillation!

I regard sugar as a greater risk to heart health than omega 6 fats.

Obesity and Overweight?

Avoid weight gain and lose weight if you are obese or overweight. (Europace, 2018; 20: 1929–35) Being overweight can drastically increase your risk of AF.

Sleep

Improve Sleep (Heart Rhythm, 2018; 15: 1289–95) – see our page on insomnia.

Don’t overwork

Overwork leads to yin deficiency which leads to yang excess. (See also Eur Heart J, 2017; 38: 2621–8)!

Your Current Medications and atrial fibrillation

Discuss possible side effects from any medications you take. (Drugs, 2012; 72: 1617–30; Drug Saf, 2009, 32; 219–28) If you diagnose atrial fibrillation, a possible cause is existing medication.

Are there any atrial fibrillation drugs to avoid?

This is an impossible question to answer!

Much depends on your current and past health, and how well you adapt to, or metabolise, any medication.

Also, every drug has a range of effects, positive and negative. You take the drug for its positive effect(s) and learn to put up with its negative effects – for which you may be given further drugs. Your doctor may be experienced, knowledgeable, helpful and sincere but you could still have a bad result because of some disagreement between the medications and your body which nobody could have foreseen.

Indeed, you might be the only person who ever experiences a particular bad reaction to the drug. (And don’t forget, please read our page on primary and secondary actions which talks about not just drugs but foods and herbs.)

All drugs attempt to alter the way your body is behaving. All drugs have side-effects, only some of which are discovered before a drug is licensed. Before taking a drug, look it up and see if the (known) positives outweigh its (known and listed) negatives.

Finally, on this vast subject of drug problems, do realise that there is a huge difference between palliation (when a drug reduces unpleasant symptoms) and cure (when the drug makes the disease and its underlying cause disappear for good).

Acupuncture

Get some acupuncture! Research shows it is almost 20% better at controlling AF that amiodarone, an antiarrhythmic drug. (Zhongguo Zhen Jiu, 2007; 27: 96–8. Also ‘Acupuncture for paroxysmal and persistent atrial fibrillation: an effective non-pharmacological tool?’ ) And … it doesn’t give you unpleasant side-effects.

Recently Italian research showed that acupuncture stopped abnormal heart rhythms from returning in AF patients who had been treated with electric shock treatment (Cardiovasc Electrophysiol, 2011; 22: 241-7) (Also see Effect of Acupuncture on Heart Rate Variability: A Systematic Review (hindawi.com)

Acupuncture treatment on upper back, a yang area.
Acupuncture for Health!

But mainly, acupuncture, being one of the treatments used in Chinese medicine, can treat whichever syndrome is causing atrial fibrillation, and has often been used for it – successfully!

Acupuncture and Chinese medicine often come closer, in my opinion, to eradicating the underlying reasons for a problem or recognising the limits of its potential cure.

Tai Qi, Qigong, Yoga

Take up Tai Qi, Qigong (BMC Complement Altern Med, 2014; 14: 8) and/or Yoga (J Am Coll Cardiol, 2013; 61: 1177–82). These help you deal with stress, and help you manage your body better. The 2011 American College of Cardiology Annual Meeting heard that 49 AF patients who took up yoga reduced the number of AF episodes by half. (Also see Atrial fibrillation: Natural treatments, remedies, and tips (medicalnewstoday.com)

Tai Qi done daily helps if you diagnose atrial fibrillation
Expand your life with Tai Qi!

Benefits come gradually and accumulate when they become daily habits.

Vegetables

Eat more vegetables: this particularly applies to post-menopausal women who eat lots of meat (proceedings of the American Heart Association scientific sessions 2016, November 14, 2016). But most people should eat more vegetables: they provide the quality our blood needs to combat disease. Only a few, probably very Blood deficient people, should eat more meat. See our page on the advantages and disadvantages of meat.

Air

Breathe! Blood clots are heavy, thick, dark – very yin in nature. Oxygen is comparatively yang in nature, being light, and energy enhancing. Fight the tendency for yin to form, with its opposite, yang. So improve your body’s absorption of oxygen via exercise and good breathing exercises. This is another reason to do Tai Qi, Qigong and Yoga. Deskwork is a killer of good breathing habits! If you diagnose atrial fibrillation, get out there and breathe!

Also do the nitric oxide ‘dump’! (www.nitricoxidedump.com)

Diets and Supplements for Atrial Fibrillation

Supplements are great but food should be your first medicine.
Food, your first medicine.

If you diagnose atrial fibrillation, before embarking on supplements as recommended below, please read my disclaimer.

I may know a little about Chinese medicine, and before recommending supplements I do research them, but there has been much less research into which supplements work, or don’t work, with other supplements, let alone with any medication you take.

Something I suggest below may not actually suit YOU. Please be responsible for yourself and don’t rush out and buy everything I mention, take too much of it and then blame me!

Again, please read my disclaimer!

Diet for Atrial Fibrillation

If you diagnose atrial fibrillation and want a single diet that helps your heart and is easy to remember and put into practice, then the Mediterranean diet is probably your best choice. (Nutr Metab Cardiovasc Dis, 2013; 23: 115–21)

This isn’t a particularly warming diet, however, and as you’ll have read, above, if you are yang deficient or have Blood stasis, I think, based on Chinese medicine, that you should take more warming foods, perhaps before and after your Mediterranean diet meal. Perhaps some warm soup, or a warm baked potato? And afterwards, maybe a warm green tea?

And chew well – chewing makes a huge difference to how easily you digest food and if you are yang deficient, unchewed food takes more Stomach Qi (ie yang) energy to digest than well-chewed food.

Of course, if your problem comes from yang excess, then the Mediterranean diet, with all those fresh salads, olive oil and oily fish, is just great for you.

(No ice-cream, however: that’s definitely not part of the diet! Even if, when you visit the Mediterranean seaside, you make a point of having ice-cream!)

Supplements for Atrial Fibrillation

Again !! – read my Disclaimer !!!

If you diagnose atrial fibrillation, before you start taking supplements, please find out if you are considered, either by Western or Chinese medicine, to be Blood deficient, or Anaemic. That’s important because any deficiency can upset everything else, confusing the real picture.

If there is Blood deficiency, you are even more susceptible to Blood stasis. Potentially, that’s your sudden lights out! Also, if very Blood deficient, avoid Turmeric. Why avoid Turmeric? See my page on it at Curcumin Benefits: How to Take Turmeric and Ginger – Acupuncture Points (acupuncture-points.org)

So, please pay attention to your nutritional status.

You may need to improve your diet and cut out foods or drinks, or reduce them substantially, if they interfere with how you absorb nutrients from what you eat. (For instance, avoid alcohol and greasy, fatty foods if you are yang excess, and avoid iced, cold and dairy foods if you are diagnosed as having phlegm or are yin-excess. Note, that’s just for instance!)

Magnesium and atrial fibrillation

Hazelnuts contain magnesium, often good when you diagnose atrial fibrillation
Hazelnuts for atrial health!

Cardiac rhythm abnormalities, including arrhythmias, have been linked to deficiencies of Magnesium (Am J Cardiol, 1986; 57: 956-9) (Am J Cardiol, 1993; 72: 1156–62, also Am Heart J, 1977; 94: 649–57 and Am J Cardiol, 1994; 74: 232–5). In some cases Magnesium acts rather like nature’s own calcium-channel blocker (Am Heart J, 1984; 108: 188–93). A lack of Magnesium might lead to Blood deficiency.

Foods containing magnesium include legumes, nuts (eg almonds, hazelnuts and walnuts), seeds, whole grains and spinach.

Potassium and atrial fibrillation

Potassium, in particular, helps patients with high blood pressure who are taking diuretics (Int J Cardiol, 1989; 25: 93–7 and Am J Cardiol, 1994; 74: 232–5). Nowadays doctors are aware of the need for potassium if they prescribe diuretics so many prescriptions contain potassium.

Coenzyme Q10 (ubiquinol) and atrial fibrillation

Researchers found ubiquinol reduced AF when patients took it along with their prescribed medication (J Investig Med, 2015; 63: 735–9. See also https://onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12539 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566449/) The older or more ill you are, the more ubiquinol you probably need. Lacking this could lead to Blood deficiency.

Omega-3 fatty acids and atrial fibrillation

Omega-3 from fish oil helps some people avoid fatal arrhythmia. (Prostaglandins Leukot Essent Fatty Acids, 2004; 71: 153–9; Circulation, 2005; 112: 2762–8). (NB as explained above, you should probably reduce foods containing omega 6 fats: linoleic acid – LA – which work in (sort of) the opposite way to omega 3 fats.). Lacking this could be a cause of Blood deficiency.

Foods high in Omega-3 fatty acids include flaxseeds, chia seeds, oily fish, walnuts, tofu, brussels sprouts, and avocados.

Of these, oily fish is the easiest to absorb omega-3 fatty acids from. (If you want to know more, much more, about the whole important question of fatty acids, read Fats that Heal Fats that Kill by Udo Erasmus.)

NAC (N-acetylecysteine) and atrial fibrillation

This  reduces AF when taken with prescribed medication after surgery. (Eur Heart J, 2008; 29: 625–31 and BMC Cardiovasc Disord, 2012; 12: 10)

NAC inhibits inflammation because your body uses it to manufacture glutathione, an important anti-oxidant. As such it can reduce the build-up of cytokines after exercise (Antioxidants attenuate the plasma cytokine response to exercise in humans – PubMed (nih.gov)) and this may reduce the inflammatory effects of Blood stasis.

In general, adequate glutathione helps your body function better even if research hasn’t shown it is specifically good for AF and heart health. NAC also reduces blood coagulation. (https://pubmed.ncbi.nlm.nih.gov/16607076/)

Caffeine and atrial fibrillation

Coffee may help when you diagnose atrial fibrillation from yang deficiency.
A little coffee may help yang deficiency-type atrial fibrillation.

The evidence is conflicting, some saying there is no relationship between arrhythmia and caffeine (Arch Intern Med, 2004; 164: 1993-8) and other research saying regular coffee helps maintain heart health. (I suspect the confusion arises because they didn’t differentiate survey patients between AF from yang excess or from yang deficiency, taking into account yin deficiency syndromes and excess-yin factors.)

From the Chinese medicine perspective, I suggest that people with overall Yang deficiency probably do benefit from a small amount of coffee, whereas those with yin deficiency should avoid it. (Coffee, Yin, Yang, Blood and Qi – Acupuncture Points (acupuncture-points.org))

If  your atrial fibrillation comes from yang excess, I believe that you should definitely avoid caffeine.

Vitamin C

This is another anti-oxidant that, like NAC, helps your heart function better, as research on its use with beta-blockers before and after heart surgery shows (Tex Heart Inst J, 2007; 34: 268–74). It comes from fresh fruit and green vegetables, but cooking destroys it.

Vitamin D and atrial fibrillation

D is thought to benefit your atrioventricular node function. (Geriatrics, 1990; 45: 83-5) Ideally you should build up your body’s vitamin D through sun exposure but however you get Vit D, realise that it triggers Nitric Oxide production to dilate your blood vessels, which lowers your blood pressure – for most people, a good thing. (Actually I suspect that it regulates or normalises blood pressure, so if you have low BP, D may help to raise it: if high, it helps to lower it. However, too much sun exposure might be bad for someone with very fast heartbeat, from Heart Fire, for instance.)

Turmeric (curcumin)

Turmeric is a herb, much used in Indian cookery, that moves Blood. Not so good if you suffer from Blood deficiency, however. See my page on how (and IF) to take turmeric.

Dark Chocolate and atrial fibrillation

Danish research showed that, for men, eating two to six servings per week of dark chocolate reduced AF by 20%. (Heart, 2017; 103: 1163–7)

That is because, in my opinion, it shares with caffeine some yang qualities but without the nutritional deficiencies of coffee. (See my page on coffee.) As with coffee or caffeine, taking dark chocolate near bedtime may interfere with sleep so enjoy it earlier in the day.

Quercetin and atrial fibrillation

If you diagnose atrial fibrillation, why Quercitin? Quercitin helps your Heart muscles work more smoothly by reducing the build-up of fats in your blood vessels. It has many other benefits (eg on blood pressure), not least if you have a remaining pathogenic factor. Lots or research on it. (https://pubmed.ncbi.nlm.nih.gov/31816893/ also J Am Heart Assoc. 2016 Jul 12;5(7). pii: e002713)

Quercitin is found in the skin and leaves of plants and fruits, and boosted by sunlight, so fruit from the top of a tree probably has more of it than fruit picked from lower branches. So do wash, but don’t peel the fruit you eat, because if you just eat the inside, or take it as a juice or squash, you won’t get the skin and its quercitin. Lots of quercitin in cherry tomatoes, apples, kale, broccoli and blueberries.

Cranberries

Researchers at Kind’s College, London found that half a cup (100gm) of cranberries daily improved blood flow functions, due to polyphenols in the fruit which aided heart and artery function. (Source: Food & Function, 2022; doi: 10.1039/D2FO0008OF)

Traditionally, cranberries help with a condition in Chinese medicine called Damp-Heat, often appearing as urinary tract infections.

However, another related fruit, Bilberry, is listed in Peter Holmes’ ‘The Energetics of Western Herbs‘ as “vitalising the Blood, astringing and strengthening the capillaries, raising Central Qi and stopping prolapse”. (Bilberries are also listed as being able to clear damp-heat.)

Just remember that pretty well all fruit has benefits for  your circulation, unless  you eat too much of it when its sugars may overwhelm your pancreas. But then, eating too much of something is never sensible, and certainly not part of the Mediterranean diet.

Disclaimer – again!

Most of the research on these supplements, you will note, relates to use in particular circumstances, which may not relate to your circumstances. So take care. Again, please read my Disclaimer!

Summarising How to Diagnose Atrial Fibrillation with TCM Chinese medicine

Summarizing how to diagnose atrial fibrillaton with Chinese medicine
Summarizing!

Over-simplifying, if you diagnose atrial fibrillation … AF, in Chinese medicine, occurs when there is:

Excess Yang

… (in the form of Heat, Fire or Qi Stagnation), which can be exacerbated if you also have Deficient Yin. Excess yang quickens your heartbeat and heats and dries Blood, leading to Blood stasis.

Recommendations:

  • If your problem comes from excess yang: using the ideas behind Chinese medicine, get acupuncture or Chinese herbs to steady the syndromes in question, cool the Heat, to move Blood and regulate your metabolism.
  • Ask your doctor to test if you are taking adequate magnesium.
  • Avoid diet and foods that increase yang, ie warming  or hot foods and …
  • Eat more food that is cooling.
  • The Mediterranean diet would be good for you. You’d feel better from it! And chew well! With this diet,  you probably don’t need extra Vitamin C.
  • Keep warm but don’t over-heat, say from exercise or sunbathing.
  • Avoid stimulant drugs, caffeine, dark chocolate, very spicy, hot, food, and greasy, fat-ful food.
  • Beware too much sugar – it tends to create fat, which stops you from cooling down, so you retain heat more easily. And it could give you diabetes, which you definitely don’t need.
  • Light sunshine is good.
  • So also should be quercitin and ubiquinol.
  • Beware stress, which increases qi stagnation which leads to Heat, which may lead to Heart Fire syndromes.

Deficient Yang

… which leads to a slower heartbeat and Blood stasis. Deficient yang can come from deficient yin in your heart the beat of which is therefore not stabilised. Deficient yang can be made worse by Cold, Damp and Phlegm.

Recommendations:

  • Acupuncture and herbs to strengthen yang (probably acupuncture would use moxa too) and move Blood.
  • Avoid cooling food and eat more warming food.
  • The Mediterranean diet might suit you if you ate it with warm, cooked vegetables and fish and/or took warm food or drink before and afterwards. And chew well! With this diet,  you probably don’t need extra Vitamin C.
  • Keep warm.
  • Lots of oily fish in your diet, and/or omega-3 oils.
  • Take quercitin and ubiquinol. Maybe NAC too.
  • Lots of rest and sleep.
  • Don’t overwork. Let someone else, probably younger, take the stress.
  • Do the nitric oxide dump regularly, not least to help you keep warm.
  • Enjoy the occasional black coffee, and/or dark chocolate.
  • Plenty of sunshine – though not so much you burn.

 

One more thing … I haven’t mentioned it because it would make this page even longer, but Kidney function and energy underlies all this. For health, good jing-essence and Kidney function are vital.

Acupuncture and Chinese herbal formulae can improve the underlying syndromes which make you susceptible to Atrial Fibrillation. Furthermore, if you diagnose atrial fibrillation, Chinese cultural know-how may lead you to better health choices.

(What do I take? Aged 76, with some AF, from yang deficiency, I mainly take extra Vit C, plus Q10, fish oils, quercitin and NAC. And I take Chinese herbs to move Blood and tonify yang. Oh! And dark chocolate, almost daily, though not a lot of it. My diet is also pretty good, at least in my opinion! …  However, it’s not exactly the Mediterranean diet.)

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