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Tachycardia

Tachycardia

12 Ways to Calm a Rapid Heartbeat

It comes on suddenly. You're not even aware of your heart and then—boom!—it starts pounding furiously. Seventy-two beats a minute become 120—180—200 beats in seconds flat. Maybe your breath catches, too, and a wave of nausea rises with your panic. You even start to sweat.

Your doctors says you have tachycardia, more specifically, paroxysmal atrial tachycardia. You're no dummy. The first time this happened, you had yourself thoroughly checked over. Together, you and your doctor ruled out ventricular tachycardia (a potentially life-threatening type of rapid heartbeat) and all forms of organic heart disease, thyroid abnormalities, pulmonary malfunctions, etc. That was reassuring.

Yet, every so often, your atria—the chambers in your heart that receive blood from the veins and pump it into the ventricles—get a little out of control. The atria keep a steady rhythm but that rhythm can be three times faster than normal. (Tachycardia, by the way, refers to any heartbeat faster than 100 beats per minute.)

There are ways to put the brakes on your tachycardia. Below, you'll find techniques to help you cope with attacks, and lifestyle tips that can help prevent them.

Slow down. Think of that speeding heart as a flashing red light that says "stop what you're doing. Chill out. Rest." Rest, in fact, is your best mechanism for stopping an attack, says Dennis S. Miura, M.D., Ph.D., director of clinical arrhythmia and electrophysiology science at the Albert Einstein College of Medicine of Yeshiva University.

Try the vagal maneuver. How fast your heart beats and how strongly it contracts are regulated by sympathetic nerves and parasympathetic nerves (or vagal nerves). When your heart pounds, the sympathetic network is dominant. (That's the system that basically tells your body to speed up.) What you want to do is switch control to the mellower parasympathetic network. If you stimulate a vagal nerve, you initiate a chemical process that affects your heart the same way that slamming on the brakes affects your car.

One way to do this is to take a deep breath and bear down, as if you were having a bowel movement, says John O. Lawder, M.D., a family practitioner specializing in nutrition and preventive medicine in Torrance, California.

Reach for the right carotid artery. Gently massaging the right carotid artery is another vagal maneuver. Be sure to have your doctor show you the right point and the right degree of pressure. You want to massage the artery where it connects in the neck, as far underneath the jaw as possible, says James Frackelton, M.D., a Cleveland physician who researches and specializes in vascular disease and immunology.

Rely on the diving reflex. When sea mammals dive into the coldest regions of the water, their heart rates automatically slow. That's nature's way of preserving their brains and hearts. You can call on your own diving reflex by filling a basin with icy water and plunging your face into it for a second or two.

"Sometimes, that will interrupt the tachycardia," says Dr. Miura.

Break the coffee habit. Ditto for cola, tea, chocolate, diet pills, or stimulants in any form. Overuse of stimulants can put you at risk for paroxysmal atrial tachycardia, says Dr. Miura.

Baby your hypothalamus. What goes on in your head—your midbrain specifically—rules your heart, says Dr. Frackelton. That's why it's essential for you to give your hypothalamus the support it needs—through proper diet, exercise, a positive attitude—to maintain stability and control over your autonomic nervous system.

The autonomic nervous system has two subsystems: the sympathetic, which basically speeds up everything in the body but digestion, and the parasympathetic system.

Stress, poor diet, and pollutants can cause your hypothalamus to lose its grip on the autonomic nervous system, allowing the system to slip into high gear or what Dr. Frackelton terms sympathetic overload. "That's Barney Fife a half hour before his execution."

You can help your hypothalamus retain control.

Eat healthy, regular meals and go easy on the sweets. If you skip meals and then fill your stomach with a candy bar or soda pop, your pancreatic enzymes will speed in to take care of the increased sugar intake, says Dr. Frackelton. Then your insulin overshoots and you go into reactive hypoglycemia. Your adrenal glands bring adrenaline in to mobilize the stores of glycogen in your liver. The adrenaline stimulates a sudden increase in heart rate and the feeling of panic.

Tailor your meal schedule to your metabolism. People who have a rapid metabolism should eat more protein foods, says Dr. Lawder. Protein foods take longer to digest and help prevent your blood sugar from falling too low. When your blood sugar drops, it triggers the process discussed above.

Let loose. Dr. Lawder says he's noticed a relationship between perfectionistic, upwardly mobile, outer-success-oriented individuals and atrial paroxysmal tachycardia. "By and large, these are the same people who get migraine headaches," he says. "For people like this, the conduction mechanisms of the heart become highly exaggerated. There's chronic adrenaline overstimulation. When people are under a lot of stress, there is a breakthrough of autonomic conduction of the heart, a loss of rhythm."

How to compensate? Adopt a progressive relaxation program, practice biofeedback, or learn to visualize "serenity, tranquility, calmness, and peace," says Dr. Lawder.

MEDICAL ALERT The Serious Side of Arrhythmia Listen, we don't mean to alarm you unnecessarily. But if your ticker has lost its sense of timing, get to a doctor—pronto. Only a doctor can distinguish between paroxysmal atrial tachycardia and more serious forms of heart arrhythmia, says Arthur Selzer, M.D., a clinical professor of medicine at the University of California Medical School. Ventricular tachycardia is an example of a more serious kind. That's what you have when one ventricle starts beating rapidly with a slightly irregular rhythm. (The ventricle is the heart chamber that pumps blood back into the arteries.) The amount of blood your heart returns to the arteries may drop markedly. You feel weak, sweaty; you may even faint. Ventricular fibrillation—which sometimes occurs as a complication of ventricular tachycardia—is usually fatal. That's why we can't stress enough the importance of attending to any abnormal heart rhythms immediately. The right response to an attack depends on what the malfunction is.

Get your fair share of magnesium. Magnesium is a protector of the cells, says Dr. Frackelton. In the muscle cells of the heart, magnesium helps to balance the effects of calcium. When calcium moves into the cells, it stimulates muscular contractions within the cell itself. Magnesium is central to the enzymes in the cell that pump calcium out. It creates rhythmic contraction and relaxation. It makes the heart much less likely to get irritable, says Dr. Frackelton. Magnesium can be found in such things as soybeans, nuts, beans, and bran.

Keep potassium levels up. Potassium is another of the minerals that helps slow down heart action and the irritability of the muscle fibers, says Dr. Lawder. The mineral is found in fruit and vegetables, so getting enough shouldn't be difficult. But you can deplete it if your diet is high in sodium or if you use diuretics (water pills) or overuse laxatives.

Exercise. "You can do a lot by getting into good tone," says Dr. Frackelton. "When you do the kinds of exercise that raise the heart rate, it tends to reset at a lower level. People who don't exercise usually have a heart rate around 80. When they begin to do a little bit of jogging, their heart rates go up to 160, 170. Then, with a little conditioning, they can bring the resting heart rate down to 60 to 65."

Exercise also makes you resistant to excess adrenaline release, he says. "It gets your aggressions out in a healthy way. You're using adrenaline release as part of a normal function."

PANEL OF ADVISERS

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James Frackelton, M.D., is in private practice in Cleveland, Ohio, and does research on vascular disease and immunology. He is past president of the American College of Advancement in Medicine and president of the American Institute of Medical Preventics.

John O. Lawder, M.D., is a family practitioner specializing in nutrition and preventive medicine in Torrance, California.

Dennis S. Miura, M.D., Ph.D., is director of clinical arrhythmia and electrophysiology science at the Albert Einstein College of Medicine of Yeshiva University in New York City.

Arthur Seizer, M.D., is a clinical professor of medicine at the University of California, San Francisco, School of Medicine and clinical professor emeritus at Stanford University. He is also a member of the cardiology staff of Pacific-Presbyterian Medical Center, where he served as department chief for 25 years.