Arrhythmia

By John Douillard, DC, PhD

In Ayurveda, the condition we know as arrhythmia (heartbeat irregularity) falls under the general classification Hrdoga (heart disease). Under this general heading, the Ayurvedic texts list the causes of heart disease, they are:

"Physical exertion, drastic and excessive purgation and enema, anxiety, fear, terror and faulty management of disorders, suppression of vomiting and ama (digestive impurities), reducing and injury - these are causative factors in heart disease." CA.Chik.26.70-73

Although Caraka often speaks in a style unfamiliar to Western medicine, a close look at this quote reveals the relevant causes of heart disease and Arrhythmia in our culture.

Ayurvedic medicine understood stress to be the cause of all disease some 5000 years ago while it has been only recently that this concept has attained Western medical acceptance. Ayurvedic doctors also knew that this stress, be it mental, physical or emotional, would lodge toxins deeply into the tissues. Depending on the genetic predisposition (body type) of the individual, a specific disease would manifest. In Caraka, most diseases are prefaced with a list of common stressors that would likely cause a specific disease. In this case, the words anxiety, terror and fear come close to describing the stressful state many of us currently experience.We live in an unprecedented time of excess. Our nervous systems are incessantly pushed to and beyond our limits. In nature, life is peaceful and calm. In our cities life is anything but. The stress we put on ourselves has stripped the peace and calm out of our cells and left them in a constant state of emergency (sympathetic dominance). The autonomic nervous system which includes the sympathetic and parasympathetic nervous systems are directly responsible for the regulation of the heart beat.

The sympathetic nervous system is most typically involved in arrhythmias. Over activation of the sympathetic nervous system triggered by stress will increase the rate of the sina-atrial node and increase conductibility of the heart. Basically, stress will increase the overall activity of the heart as much as three times normal rhythm. If the sympathetic activation is excessive and constant and the individual has a constitution predisposed to heart conditions - arrhythmias could be one of the first signs of heart disease.

The parasympathetic nervous system helps to slow the heartbeat by vagal nerve activation. Stimulation of the vagus nerve to the heart will trigger a release of acetylcholine to the heart. This hormone has two effects on the heart. First, it decreases the rate of rhythm of the sino-atrial node which regulates heartbeat rhythm and second it decrease heart conductibility into the ventricles. Basically, it dramatically slows and calms the heart and rarely causes arrhythmias. Actually many stress reduction techniques used for arrhythmias attempt to reactivate the parasympathetic nervous system to slow the heart and calm the nervous system. The therapeutic in this article will be focused on parasympathetic reactivation and a reduction in the sympathetic nervous system stress response.Let's look Ayurvedically at the effects of excess stress and excessive sympathetic stimulation. The first response to stress is a change in the breathing pattern from a deep to shallow breath rhythm. Under extreme stress we see a hyperventilation response where the breathing becomes shallow, labored and through the mouth. Less extreme stress will also trigger an upper chest shallow mouth breathing pattern.

When we are frightened we "gasp" a short quick mouth breath. This is an instinctive response necessary to properly activate the emergency nervous system that predominates in the upper lobes of the lungs. If the body is under stress, the breath will automatically become shallow to insure the proper emergency hormonal response.

The problem is that the rib cage has elastic recoil, which means it constantly constricts on the lungs. Over time this elastic recoil will create a rigidity in the rib cage anatomically constricting the heart and lungs. If the lower lobes are not regularly activated, then the breathing will stay shallow and the nervous system will trigger an emergency sympathetic response with each breath - 28,000 per day. Most people breathe small, shallow breaths during their daily routine and never get enough air in to reactivate the lower lobes that house the majority of the parasympathetic nervous system. (See Treatments under Breathing)In Ayurveda, the heart is understood to be more than just a pump that feeds the organs and cells. It is the seat of the intellect and senses and the reservoir of consciousness according to Caraka and the faculty of thought according to the Yoga Vasistha.

Life known by the sense perception is located in the heart. It is also the seat of excellent Ojas and the reservoir of consciousness. This is why the heart is said to be mahat (great) and artha (serving all purposes) by the physicians. From the heart as root, ten great vessels carrying Ojas pulsate all over the body. The Ojas maintains living beings by its saturation, without which no life of creatures exists. CA. SU.30.6-9

According to Ayurveda, the substance which is called Ojas is arguably the most precious in the human body. Prana owes its existence to it. It governs immunity and procreation, two functions which keep the species alive. It is also the physical expression of consciousness that is depleted by stress, affliction of mind and a host of other factors.

Although Arrhythmias involve all three doshas, Vata, Pitta and Kapha, Vata is most likely the cause of heartbeat irregularities.

"In predominance of Vata, particularly there are vacantness in the heart, palpitation, wasting, tearing, obstructed movement and mental confusion." CA.Chik.26.72.

In this quote, Caraka mentions vacantness of the heart. It is likely he is talking of a lack of Ojas which would represent a fullness of the heart. This lack of Ojas could cause palpitation and the other symptoms mentioned with reference to a Vata based Hrdoga (heart disease).

It should not be misunderstood that this condition is restricted to Vata body types. Actually, the more driven Pitta types commonly experience arrhythmias, but any body type with enough stress and a genetic susceptibility could be affected. Vata however, is usually the initial causative factor.

Further Information

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