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Tuesday, May 21, 2013

Yoga and Heart Health: Tachycardia

by Baxter

We recently received two inquiries regarding a heart condition called tachycardia. In its simplest form, this just means a heart rate that is running faster than normal. For example, the normal range for a resting heart rate is said to fall from 60-100 beats per minute. Sometimes it is considered normal to have a resting rate lower than 60. For example, in long distance runners who are very aerobically fit, a resting rate of 50 or lower could be normal and healthy. Rarely is a heart rate above 100 at rest a normal finding.
N. Watercolor 1 (The Heart Goes from Sugar to Coffee) by Kurt Schwitters 
When we are not resting, but running a sprint as an example, our heart rate will increase so that the heart can adjust to the increased demand for the blood to deliver energy to muscles and take waste products of work away. Once the immediate demands on the heart ease up, the heart rate drifts back to its normal range. In February, I did a post on a particular kind of arrhythmia that happens to involve the heart beating too fast called atrial fibrillation. This happens to be a kind of tachycardia that can lead to serious complications if left unaddressed. Other kinds of fast heart rhythms, especially if they only last for a few seconds or less than a minute, might be felt by the person experiencing them as unusual - a feeling in the chest of a rapid beat, light-headedness, shortness of breath or dizziness, but could resolve uneventfully. I’d tend to be more conservative if this was happening to me, and I’d get in to see my family doc and get an EKG and have the doc listen to my heart to make sure it is not putting me at risk.

According to the Mayo Clinic website:

 “if you have tachycardia (tak-ih-KAHR-de-uh), the rate in the upper chambers or lower chambers of the heart, or both, are increased significantly.  Heart rate is controlled by electrical signals sent across heart tissues. Tachycardia occurs when an abnormality in the heart produces rapid electrical signals.  In some cases, tachycardias may cause no symptoms or complications. However, tachycardias can seriously disrupt normal heart function, increase the risk of stroke, or cause sudden cardiac arrest or death.” 

So, even though some tachycardias may be less harmful, it’s that last sentence that should get your attention!

The causes of tachycardia are numerous, but underlying them all is something that disrupts the normal electrical impulses that control the rhythm of the heart's pumping action. There are many factors that can contribute to the development of an abnormally fast heart rate, but a few of the more common ones are:
  • High blood pressure
  • Smoking
  • Fever
  • Drinking too much alcohol
  • Drinking too many caffeinated beverages
  • A side effect of medications
  • Abuse of recreational drugs, such as cocaine
  • Imbalance of electrolytes, mineral-related substances necessary for conducting electrical impulses
  • Overactive thyroid (hyperthyroidism)
The others are usually related to other kinds of heart disease, both inherited and those that develop over time. I list the ones above because we can have more direct influences over these by lifestyle changes and choices, and yoga has been shown to help people who are wanting to make these kinds of changes (see Meditation and Healthy Eating).

In addition, the study that I alluded to in February has just been completed and published (See Effect of Yoga on Arrhythmia Burden, Anxiety, Depression, and Quality of Life in Paroxysmal Atrial Fibrillation). Not only did the study group doing yoga have improvement in their atrial fibrillation, their symptoms improved, heart rate improved, blood pressure improved, depression and anxiety scores got better and reported quality of life scores improved in some areas. A combination of asana, pranayama and meditation were part of the sequence, in the Iyengar tradition, that the participants practiced. No injuries from the yoga were reported, and they did ask and check with the students on this question. And the researchers noted that yoga’s multi-system benefits (that previous research has shown)  are probably at play here as well, especially the ability of yoga to quiet the fight-or-flight response of the nervous system.

Keep in mind, too, that if yoga is done in overly-stimulating ways, for example, moving through a rapid series of poses that gets the heart rate up high and fast, or holding poses for longer timings (5-10 minutes - especially if they are physically demanding), this could trigger a tachycardia episode in someone who is susceptible. Therefore, choosing the right practice for students with tachycardia symptoms would be very important. Even certain kinds of breath work that is stimulating to the sympathetic nervous system (fight-or-flight response), such as longer inhalations compared to the exhalation length, with holding after the inhalation, should be avoided. The opposite approach, with a longer exhalation and a gentle hold after the exhalation, has been shown to help slow the heart rate and lower blood pressure in most students.

So once again, a balanced yoga practice, with asana, relaxing breath work and conscious relaxation and/or meditation is the way to go if you have a tendency to develop abnormally fast heart rhythms.
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