Author: Dr. Vikram Chauhan

Abstract

Atrial flutter is a heart condition which is described by the increased tactile and regular ventricular rates along with atrial fibrillation. It is classified under cardiac tachyarrhythmia and is characterized by palpitations, shortness of breath and many others. Usually the prevalence of this condition increases with the increase in age and is also associated with the number of associated conditions like diabetes mellitus, respiratory disorders, hypertension, excessive alcohol intake and sometimes a person indulging in sports. In Ayurveda all the conditions of the heart are kept under the category of hridya roga and is classified under vata, pitta,kapha and krimi hridya roga. In this we will discuss Atrial flutter in detail along with its Ayurvedic management.

Introduction

Atrial flutter can be defined as the supraventricular tachycardia (abnormal heart rhythm) which is generally the result of inflammation of atrium myocardium. As mentioned above it is characterized by a fast heart beat or feeling of skipping beats. But in addition can also present with shortness of breath leading to temporary unconsciousness. The ECG presentation in this condition is given  a particular name and is called a saw tooth pattern. The reason for this presentation is the impaired ventricular functioning of about 200-300 beats per minute. Mentioning the clinical aspects, it is represented by increased beats, palpitations, lowered blood pressure  along with angina and syncope in some patients. For months it can remain asymptomatic for months and in the end has a tendency to lead to heart failure.

Causes of Atrial flutter

• The most common statement given to understand atrial flutter is increased rate of electric impulse prematurely in atria. It can be understood as one ventricular contraction followed by 4 atrial signaling.
• Secondly why does the above mentioned condition occur? This situation is commonly observed in people having associated problems like pre existing heart conditions, diabetes which generally affects every system in the body or certain substances that can change the way of electrical transmission going inside the heart.

The Heart Condition Mostly Leading Towards Atrial Flutter are

1. Ischemia leading to hardening of arteries supplying to heart
2. Cardiomyopathy which affects muscles of heart
3. Abnormal heart valves like defects in mitral valve.
4. Hypertrophy of heart chambers

Substances Which can Contribute in Atrial Flutter:

• Alcohol like beer, hard liquor, excessive wine
• Some illegal stimulants like cocaine, amphetamines (central nervous system stimulants), cold medicines and even caffeine.

Symptoms of Atrial Flutter

Many patients with atrial flutter remain asymptomatic. On the other hand some may show or describe following symptoms:

1. Palpitations (feeling a rapid heart beat or fluttering or pounding sensation in the centre of chest)
2. Shortness of breath (In this case can be only on exhaustion or even while on rest)
3. Anxiety (Triggered by a lot of factors like fear, tension, anger)
4. Confusion (Classical symptom appears after breathlessness)
5. Tiredness (Generally always present)

In addition patients with pre existing heart condition scan have more significant symptoms that includes:

• Angina pectoris, in common understood as heart pain
• Feeling faint or lightheaded
• Fainting

Diagnosis of Atrial flutter

Diagnosis is generally made based on the patient’s history and examination. This includes:

• ECG, which represents a saw tooth pattern.
• Patients proper history and  differential diagnosis with other arrhythmias.
• Differentiation from atrial fibrillation
• Detailed Examination and history of patients with no symptoms.
• In advancement of technology some 24 hrs devices can be worn by the patients and monitoring can be done like holter monitoring, event monitoring and others.

Risk Factors

1. Old age: Older the patient the more is the risk.
2. Patients with diabetes mellitus
3. Patients with various heart conditions like Coronary heart disease, heart valve disease,past history of open heart surgery etc.
4. People with habitual addiction to cocaine, alcohol, caffeine and others.

Treatment of Atrial flutter

Antiarrhythmic drug treatment can be used to convert atrial flutter to sinus rhythm by using three drugs. These are:

1. Ibutilide (only through intravenous route)
2. Flecainide
3. Propafenone

Or currently atrial flutter is successfully treated with radiofrequency catheter ablation.

But the side effects of above mentioned ways are also present like catheter ablation can lead the patients towards allergies, atrial fibrillation, stroke and if not done properly can result in tissue damage. On the other hand, continued use of antiarrhythmic drugs has the potential of creating situations like hypotension, impairment in ventricular functioning, vasodilation, pulmonary fibrosis etc.

Herbal Formulations for Atrial Flutter by Planet Ayurveda

Planet Ayurveda is a leading Ayurvedic firm which deals with the manufacturing of herbal formulations. These formulations are prepared using potent herbs which are really effective in managing many conditions related to the whole circulatory system. The formulations prepared by Planet Ayurveda do not contain any kind of adulterants, dyes, additives, fillers etc. These medications are really potent to manage various conditions related  to the heart especially and are very fruitful hence giving positive noticeable results. The medication or formulations offered by Planet Ayurveda for the management of Yellow bumps pinguecula is as follows:

1. Arjuna capsules
2. Total heart support
3. Saral Ghan vati
4. Arborium plus

PRODUCTS DESCRIPTION

1. Arjuna Capsules

Arjuna capsules are prepared with the standardised extract of Terminalia arjuna. All the parts of the plant are used to prepare the standardised extract and hence makes it really effective. The arjuna has many properties like it is a cardiotonic,  has hepatoprotective effect  and also has an immunomodulatory effect. The capsules have potential in relieving many symptoms which are significantly related to atrial flutter and balances the electrical impulse of the heart.

Dosage: One capsule twice a day after meals with lukewarm water.

2. Total Heart Support

Total heart support has ingredients like arjuna (Terminalia arjuna), brahmi (Bacopa monnieri), ashwagandha (Withania somnifera) and shankhpushpi (Convolvulus prostratus). The arjuna as mentioned above helps in treating various problems like angina, shortness of breathness due to atrial flutter, congestive heart failure and even high cholesterol. On the other hand ashwagandha helps in strengthening heart muscles, deals with arterial weakness and supports the entire system of the body. In addition, brahmi and shankhpushpi work with their rasayanic actions which means they rejuvenate cells and tissue and also protect the heart from tactile ventricular rates.

Dosage: Two capsules twice a day after meals with lukewarm water.

3. Saral Ghan Vati

Saral ghan vati has only one ingredient which is saral (Pinus roxburghii).  The formulation is prepared using saral bark especially which is known for its marvelous properties. It works as a diuretic, diaphoretic, behaves as a general tonic, has antiseptic effects and helps in reduction of spasm. It can help in maintaining the regular ventricular rates and thus helps in relieving pressure and inflammation. Moreover, it is very effective in all types of heart disease. It is rich in antioxidants, fights inflammation and also is very helpful in liver conditions.

Dosage: Two tablets twice daily after meals with lukewarm water.

4. Arborium Plus

The formulation is in syrup form and is a wonderful herbal medication which has two key ingredients. One is arborium (Rhododendron) flower juice and another is sea buckthorn flower juice (Hippophae rhamnoides). Arborium plus syrup can help in increasing the blood supply, expand blood vessels by opening the blockages, detoxifies the body and helps in lowering the blood cholesterol and blood triglyceride levels. It helps in boosting the immune system of the body.

Dosage: Two tsp twice a day after meals.

Conclusion

Today’s lifestyle and faulty diet intake has led to the increase in the incidence of cardiovascular diseases. Ayurveda because of its multidimensional aspect of ‘Swasthya-rakshanam’ and ‘vikara prashamanam’ gifted us with Ahara-vihara and Codes of conduct (Achara Rasayana) that  on practising are very effective in prevention of heart diseases. Following pathya apathya for particular disease not suppressing the natural urges(Vega), keeping check on negative emotions, use of certain Rasayana in daily routine, etc. are helpful for overcoming the pathological basis that is  ama and strotosanga. In this way, a number of drugs of different groups like Cardiotonics, Deepana & Amapachana and Rasayana ( Antioxidants) etc. have great efficacy in the management of arrhythmias like atrial flutter and atrial fibrillations.