Integrated approach to the treatment of heart failure and arrhythmias

Journal title PNEI REVIEW
Author/s Carlo Dal Lin, Raffaele Migliorini, Marco Silvestro, Sabino Iliceto, Francesco Tona
Publishing Year 2017 Issue 2017/2
Language Italian Pages 10 P. 81-90 File size 1114 KB
DOI 10.3280/PNEI2017-002008
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The integrated approach for the treatment of cardiac failure and arrhythmias involves recognizing the factors hindering the patient’s healing process and defining a path of care that meets the patient’s needs. Along with conventional therapy, we have to control those factors that may affect the delicate cardiovascular balance (correct management of hypertension and traditional cardiovascular risk factors, attention to the use of non-steroidal anti-inflammatory drugs and calcium channel blockers), and to provide adequate indications focused on patient’s lifestyle: cessation of smoking and alcohol use; proper diet (Mediterranean diet) and aerobic physical activity to achieve an adequate weight; salt and water restriction if necessary; use mind-body techniques for proper stress and depression management.

Keywords: Integrative medicine, phytotherapy, stress, lifestyle, cardiovascular prevention, cardiovascular rehabilitation.

  1. Echols M.R. and Jiang W. (2011). Clinical trial evidence for treatment of depression in heart failure. Heart Fail. Clin., 7(1): 81-88. DOI: 10.1016/J.HFC.2010.08.00
  2. Pizzorno J.E. and Murray M.T. (2013). Textbook of Natural Medicine. 4th Edition. St. Louis: Churchill Livingston Elsevier.
  3. Agatisa P.K., Matthews K.A., Bromberger J.T., Edmundowicz D., Chang Y.-F. and Sutton-Tyrrell K. (2005). Coronary and Aortic Calcifi cation in Women With a History of Major Depression. Arch. Intern. Med., 165: 1229-1236. DOI: 10.1001/ARCHINTE.165.11.122
  4. Albert C.M., Manson J.E., Cook N.R., Ajani U.A., Gaziano J.M. and Hennekens C.H. (1999). Moderate alcohol consumption and the risk of sudden cardiac death among US male physicians. Circulation, 100: 944-950. DOI: 10.1161/01.CIR.100.9.94
  5. Beery T.A., Baas L.S., Fowler C. and Allen G. (2002). Spirituality in persons with heart failure. J. Holist. Nurs., 20(1): 5-25. DOI: 10.1177/08980101020200010
  6. Bekelman D.B., Rumsfeld J.S., Havranek E.P., Yamashita T.E., Hutt E., Gottlieb S.H., Dy S.M. and Kutner J.S. (2009). Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients. J. Gen. Intern. Med., 24(5): 592-598. DOI: 10.1007/S11606-009-0931-
  7. Bharani A., Ganguly A. and Bhargava K.D. (1995). Salutary effect of Terminalia Arjuna in patients with severe refractory heart failure. Int. J. Cardiol., 49(3): 191-199. DOI: 10.1016/0167-5273(95)02320-
  8. Camm A.J., Luscher T.F. and Serruys P.W. (2009). ESC Textbook of Cardiovascular Medicine Second Edition., Oxford: Oxford University Press.
  9. Coats A.J.S., Adamopoulos S., Meyer T.E., Conway J. and Sleight P. (1990). Effects of physical training in chronic heart failure. Lancet, 335(8681): 63-66. DOI: 10.1016/0140-6736(90)90536-
  10. Cohen N., Alon I., Almoznino-Sarafi an D., Weissgarten J., Gorelik O., Berman S., Zaidenstein R., Golik A. and Modai D. (2000). Metabolic and clinical effects of oral magnesium supplementation in furosemide-treated patients with severe congestive heart failure. Clin. Cardiol., 23(6): 433-436. DOI: 10.1002/CLC.496023061
  11. Dal Lin C., Poretto A., Scodro M., Perazzolo Marra M., Iliceto S. and Tona F. (2015a). Coronary microvascular and endothelial function regulation: Crossroads of psychoneuroendocrineimmunitary signals and quantum physics [Part A]. J. Integr. Cardiol., 1(5): 132-163. DOI: 10.15761/JIC.100013
  12. Dal Lin C., Poretto A., Scodro M., Perazzolo Marra M., Iliceto S. and Tona F. (2015b). Coronary microvascular and endothelial function regulation: Crossroads of psychoneuroendocrineimmunitary signals and quantum physics [Part B]. J. Integr. Cardiol., 1(5): 164-188. DOI: 10.15761/JIC.100013
  13. Dal Lin C., Poretto A., Scodro M., Perazzolo Marra M., Iliceto S. and Tona F. (2015c). Coronary microvascular and endothelial function regulation: Crossroads of psychoneuroendocrineimmunitary signals and quantum physics [Part C]. J. Integr. Cardiol., 1(5): 189-209. DOI: 10.15761/JIC.100013
  14. Dimopoulos S., Anastasiou-Nana M., Sakellariou D., Drakos S., Kapsimalakou S., Maroulidis G., Roditis P., Papazachou O., Vogiatzis I., Roussos C. and Nanas S. (2006). Effects of exercise rehabilitation program on heart rate recovery in patients with chronic heart failure. Eur. J. Cardiovasc. Prev. Rehabil., 13(1): 67-73. DOI: 10.1097/01.HJR.0000198449.20775.7
  15. Ferketich A.K., Ferguson J.P. and Binkley P.F. (2005). Depressive symptoms and inflammation among heart failure patients. Am. Heart J., 150(1): 132-136. DOI: 10.1016/J.AHJ.2004.08.02
  16. Fioranelli M., editor (2017). Integrative Cardiology. 1st ed., Cham: Springer International Publishing. DOI: 10.1007/978-3-319-40010-
  17. Fitchett G., Murphy P.E., Kim J., Gibbons J.L., Cameron J.R. and Davis J.A. (2004). Religious struggle: prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. Int. J. Psychiatry Med., 34(2): 179-196. DOI: 10.2190/UCJ9-DP4M-9C0X-835
  18. Gottlieb S.S., Baruch L., Kukin M.L., Bernstein J.L., Fisher M.L. and Packer M. (1990). Prognostic importance of the serum magnesium concentration in patients with congestive heart failure. J. Am. Coll. Cardiol., 16(4): 827-831. DOI: 10.1016/S0735-1097(10)80329-
  19. Graboys T.B. (1984). Stress and the aching heart. N. Engl. J. Med., 311: 594-595. DOI: 10.1056/NEJM19840830311090
  20. Graboys T.B. and Lown B. (1983). Coffee, arrhythmias, and common sense. N. Engl. J. Med., 308: 835-837. DOI: 10.1056/NEJM19830407308140
  21. Guck T.P., Elsasser G.N., Kavan M.G. and Barone E.J. (2003). Depression and congestive heart failure. Congest. Heart Fail., 9(3): 163-169. DOI: 10.1111/J.1527-5299.2003.01356.
  22. Gunda S., Kanmanthareddy A., Atkins D., Bommana S., Pimentel R., Drisko J., Dibiase L., Beheiry S., Hao S., Natale A. and Lakkireddy D. (2015). Role of yoga as an adjunctive therapy in patients with neurocardiogenic syncope: a pilot study. J. Interv. Card. Electrophysiol., 43(2): 105-110. DOI: 10.1007/S10840-015-9996-
  23. Harvey W. (1628). On the Motion of the Heart and Blood in Animals. Vol. 38, Part 3. Harvard Classics. New York: P.F. Collier Son, 1909-14; Bartleby.com, 2001.
  24. Hinkle L.E., Thaler H.T., Merke D.P., Renier-Berg D. and Morton N.E. (1988). The risk factors for arrhythmic death in a sample of men followed for 20 years. Am. J. Epidemiol., 127(3): 500-515. DOI: 10.1093/OXFORDJOURNALS.AJE.A11482
  25. Jayadevappa R., Johnson J.C., Bloom B.S., Nidich S., Desai S., Chhatre S., Raziano D.B. and Schneider R. (2007). Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. Ethn. Dis., 17(1): 72-77.
  26. Jha P., Flather M., Lonn E., Farkouh M. and Yusuf S. (1995). The Antioxidant Vitamins and Cardiovascular Disease: A Critical Review of Epidemiologic and Clinical Trial Data. Ann Intern Med., 123(11): 860-872. DOI: 10.7326/0003-4819-123-11-199512010-0000
  27. Jiang W., Alexander J., Christopher E., Kuchibhatla M., Gaulden L.H., Cuffe M.S., Blazing M.A., Davenport C., Califf R.M., Krishnan R.R. and O’Connor C.M. (2001). Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch. Intern. Med., 161(15): 1849-1856. DOI: 10.1001/ARCHINTE.161.15.184
  28. Jónsdóttir S., Andersen K.K., Sigurosson A.F. and Sigurosson S.B. (2006). The effect of physical training in chronic heart failure. Eur. J. Heart Fail., 8(1): 97-101. DOI: 10.1016/J.EJHEART.2005.05.00
  29. Kanmanthareddy A., Reddy M., Ponnaganti G., Sanjani H.P., Koripalli S., Adabala N., Buddam A., Janga P., Lakkireddy T., Bommana S., Vallakati A., Atkins D. and Lakkireddy D. (2015). Alternative medicine in atrial fi brillation treatment-Yoga, acupuncture, biofeedback and more. J. Thorac. Dis., 7(2): 185-192. DOI: 10.3978/J.ISSN.2072-1439.2015.01.1
  30. Kessel L. (1990). Sick sinus syndrome cured by vitamin D?. Geriatrics, 45(8): 83-85.
  31. Koenig H.G., Cohen H.J., George L.K., Hays J.C., Larson D.B. and Blazer D.G. (1997). Attendance at religious services, interleukin-6, and other biological parameters of immune function in older adults. Int. J. Psychiatry Med., 27(3): 233-250. DOI: 10.2190/40NF-Q9Y2-0GG7-4WH
  32. Korantzopoulos P., Kolettis T.M., Kountouris E., Dimitroula V., Karanikis P., Pappa E., Siogas K. and Goudevenos J.A. (2005). Oral vitamin C administration reduces early recurrence rates after electrical cardioversion of persistent atrial fibrillation and attenuates associated inflammation. Int. J. Cardiol., 102(2): 321-326. DOI: 10.1016/J.IJCARD.2004.12.04
  33. Kristen A.V., Schuhmacher B., Strych K., Lossnitzer D., Friederich H.-C., Hilbel T., Haass M., Katus H.A., Schneider A., Streitberger K.M. and Backs J. (2010). Acupuncture improves exercise tolerance of patients with heart failure: a placebo-controlled pilot study. Heart, 96: 1396-1400. DOI: 10.1136/HRT.2009.18793
  34. Langsjoen P.H. and Langsjoen A.M. (1999). Overview of the use of CoQ10 in cardiovascular disease. Biofactors, 9(2-4): 273-284. DOI: 10.1002/BIOF.552009022
  35. Lau E.W., Birnie D.H., Lemery R., Tang A.S.L. and Green M.S. (2005). Acupuncture triggering inappropriate ICD shocks. Europace, 7(1): 85-86. DOI: 10.1016/J.EUPC.2004.05.01
  36. Levin J.S. (1996). How prayer heals: a theoretical model. Altern. Ther. Health Med., 2(1):66-73.
  37. Lloyd-Jones D., Adams R.J., Brown T.M., Carnethon M., Dai S., De Simone G., Ferguson T.B., Ford E., Furie K., Gillespie C., Go A., Greenlund K., Haase N., Hailpern S., Ho P.M., Howard V., Kissela B., Kittner S., Lackland D., Lisabeth L., Marelli A., McDermott M.M., Meigs J., Mozaffarian D., Mussolino M., Nichol G., Roger V.L., Rosamond W., Sacco R., Sorlie P., Stafford R., Thom T., Wasserthiel-Smoller S., Wong N.D. and Wylie-Rosett J. (2010). Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation, 121(7): e46-e215. DOI: 10.1161/CIRCULATIONAHA.109.19266
  38. Lomuscio A., Belletti S., Battezzati P.M. and Lombardi F. (2011). Effi cacy of acupuncture in preventing atrial fibrillation recurrences after electrical cardioversion. J. Cardiovasc. lectrophysiol., 22(3): 241-247. DOI: 10.1111/J.1540-8167.2010.01878.
  39. Middlekauff H.R. (2004). Acupuncture in the treatment of heart failure. Cardiol. Rev., 12: 171-173. DOI: 10.1097/01.CRD.0000103650.71735.F
  40. Moser D.K., Dracup K., Woo M.A. and Stevenson L.W. (1997). Voluntary control of vascular tone by using skin-temperature biofeedback-relaxation in patients with advanced heart failure. Altern. Ther. Health Med., 3(1): 51-59.
  41. Myers M.G. and Harris L. (1990). High dose caffeine and ventricular arrhythmias. Can. J. Cardiol., 6(3): 95-98.
  42. Najafi M., Garjani A., Maleki N. and Eteraf Oskouei T. (2008). Antiarrhythmic and arrhythmogenic effects of L-carnitine in ischemia and reperfusion. Bull. Exp. Biol. Med., 146(2): 210-213. DOI: 10.1007/S10517-008-0249-
  43. O’Connor C.M., Whellan D.J., Lee K.L., Keteyian S.J., Cooper L.S., Ellis S.J., Leifer E.S., Kraus W.E., Kitzman D.W., Blumenthal J.A., Rendall D.S., Miller N.H., Fleg J.L., Schulman K.A., McKelvie R.S., Zannad F. and Piña I.L. (2009). Efficacy and safety of exercise training in patients with chronic heart failure. HF-ACTION randomized controlled trial. JAMA, 301(14): 1439-1450. DOI: 10.1001/JAMA.2009.454
  44. Oman D. and Reed D. (1998). Religion and mortality among the community-dwelling elderly. Am. J. Public Health, 88(10): 1469-1475. DOI: 10.2105/AJPH.88.10.146
  45. Pittler M.H., Guo R. and Ernst E. (2008). Hawthorn extract for treating chronic heart failure. Cochrane database Syst. Rev., 1: CD005312. DOI: 10.1002/14651858.CD005312.PUB
  46. Pucciarelli G., Mastursi M., Latte S., Sacra C., Setaro A., Lizzadro A. and Nolfe G. (1992). The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure. Clin. Ter., 141 (11): 379-384.
  47. Rakel D. (2012). Integrative Medicine. 3rd Edition. Philadelphia: Elsevier Saunders.
  48. Rector T.S., Bank A.J., Mullen K.A., Tschumperlin L.K., Sih R., Pillai K. and Kubo S.H. (1996). Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation, 93: 2135-2141. DOI: 10.1161/01.CIR.93.12.213
  49. Sellmayer A., Witzgall H., Lorenz R.L. and Weber P.C. (1995). Effects of dietary fish oil on ventricular premature complexes. Am. J. Cardiol., 76(12): 974-977. DOI: 10.1016/S0002-9149(99)80276-
  50. Skyrme-Jones R.A., O’Brien R.C., Berry K.L. and Meredith I.T. (2000). Vitamin E supplementation improves endothelial function in type I diabetes mellitus: a randomized, placebocontrolled study. J. Am. Coll. Cardiol., 36(1): 94-102. DOI: 10.1016/S0735-1097(00)00720-
  51. Sullivan M.J., Wood L., Terry J., Brantley J., Charles A., McGee V., Johnson D., Krucoff M.W., Rosenberg B., Bosworth H.B., Adams K. and Cuffe M.S. (2009). The Support, Education, and Research in Chronic Heart Failure Study (SEARCH): A mindfulness-based psychoeducational intervention improves depression and clinical symptoms in patients with chronic heart failure. Am. Heart J., 157(1): 84-90. DOI: 10.1016/J.AHJ.2008.08.03
  52. Suzuki Y., Masumura Y., Kobayashi A., Yamazaki N., Harada Y. and Osawa M. (1982). Myocardial carnitine deficiency in chronic heart failure. Lancet, 319(8263): 116.
  53. Tabet J.-Y., Meurin P., Beauvais F., Weber H., Renaud N., Thabut G., Cohen-Solal A., Logeart D. and Ben Driss A. (2008). Absence of exercise capacity improvement after exercise training program: a strong prognostic factor in patients with chronic heart failure. Circ. Heart Fail., 1: 220-226. DOI: 10.1161/CIRCHEARTFAILURE.108.77546
  54. Taggart P., Boyett M.R., Logantha S. and Lambiase P.D. (2011). Anger, emotion, and arrhythmias: from brain to heart. Front. Physiol., 2: 67. DOI: 10.3389/FPHYS.2011.0006
  55. Taylor R.S., Sagar V.A., Davies E.J., Briscoe S., Coats A.J.S., Dalal H., Lough F., Rees K. and Singh S. (2014). Exercise-based rehabilitation for heart failure. Cochrane database Syst. Rev., 4: CD003331. DOI: 10.1002/14651858.CD003331.PUB
  56. Tauchert M. (2002). Effi cacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am. Heart J., 143(5): 910-915. DOI: 10.1067/MHJ.2002.12146
  57. Vaccarino V., Votaw J., Faber T., Veledar E., Murrah N. V, Jones L.R., Zhao J., Su S., Goldberg J., Raggi J.P., Quyyumi A.A., Sheps D.S. and Bremner J.D. (2009). Major depression and coronary fl ow reserve detected by positron emission tomography. Arch. Intern. Med., 169(18): 1668-1676. DOI: 10.1001/ARCHINTERNMED.2009.33
  58. VanWormer A.M., Lindquist R. and Sendelbach S.E. (2008). The effects of acupuncture on cardiac arrhythmias: A literature review. Hear. Lung J. Acute Crit. Care, 37(6): 425-431. DOI: 10.1016/J.HRTLNG.2007.11.00
  59. Waldfogel S. (1997). Spirituality in medicine. Prim. Care, 24(4): 963-976.
  60. Westlake C. and Dracup K. (2001). Role of spirituality in adjustment of patients with advanced heart failure. Prog. Cardiovasc. Nurs., 16(3): 119-125. DOI: 10.1111/J.0889-7204.2001.00592.
  61. Yeh G.Y., Wood M.J., Lorell B.H., Stevenson L.W., Eisenberg D.M., Wayne P.M., Goldberger A.L., Davis R.B. and Phillips R.S. (2004). Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: a randomized controlled trial. The Am. J. Med., 117(8): 541-548. DOI: 10.1016/J.AMJMED.2004.04.01
  62. Zamarra J.W., Schneider R.H., Besseghini I., Robinson D.K. and Salerno J.W. (1996). Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. Am. J. Cardiol., 77(10): 867-870. DOI: 10.1016/S0002-9149(97)89184-
  63. Zenuk C., Healey J., Donnelly J., Vaillancourt R., Almalki Y. and Smith S. (2003). Thiamine deficiency in congestive heart failure patients receiving long term furosemide therapy. Can. J. Clin. Pharmacol., 10(4): 184-188.

Carlo Dal Lin, Raffaele Migliorini, Marco Silvestro, Sabino Iliceto, Francesco Tona, Approccio integrato alla cura dello scompenso cardiaco ed aritmie in "PNEI REVIEW" 2/2017, pp 81-90, DOI: 10.3280/PNEI2017-002008