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Mar 19, 2011

Anti-arrhythmic drugs in Ayurveda

 Anti-arrhythmic drugs in Ayurveda
    
-This category of drugs has the tendency to regulate the abnormalities in the heart rate. It is known fact that the heart pumps blood through out our body. Involuntary muscles of heart keeps on working even we are working, sleeping or sitting. Heart beats are produced due to the expansion and contractions of the heart muscles. in normal condition heart beats are 60 to 80 times in a minute. Pace maker is the powerhouse of the heart that is responsible for controlling the heart beat. The pace maker sends electric vibrations to different parts of heart for proper working.

These electric signals are developed in the Sino Articular node located at the upper part of right atrium. The controlled mechanism of these electric signals and other involuntary muscles leads in a rhythmic expansion and contraction in the heart that is known to be the heart beat (characterized by lub and dub sign). Any type of irregularity in heart's natural rhythm due to any reason is called an arrhythmia.

This unhealthy condition of irregular heart beat or Arrhythmias is divided into two parts

   1. Ventricular
   2. Supra-ventricular.

When the ventricles are supposed to flicker the Ventricular arrhythmias occurs. On the other hand when the atria or the upper chambers are flickering irregularly Supra-ventricular arrhythmias occur.

Further, the Arrhythmias are subdivided by the speed of the heartbeats. Following are the three conditions for Arrhythmias

The very slow heart rate is called bradycardia. In bradycardia the heart rate is less than 60 beats per minute.

Second condition is tachycardia, which means increased heart rate. In this condition the heartbeats are more than 100 beats per minute.

The most difficult of the arrhythmia is fibrillation. In this condition the heartbeats are uncoordinated, that means the expansion and contractions of individual heart-muscle fibers are independent from each other.

There are various causes for arrhythmia. It can be congenital, due to pathological conditions, different cardiac diseases, hypertension, stress, smoking and alcohol. Some medicines also affect the heart beat pattern. Following are the symptoms of the arrhythmic conditions.

In bradycardia the patient feel tired, short of breath, dizziness, or some times he faints.

The patient with tachycardia has a feeling of strong pulse in his neck, and fluttering, racing beat in his chest. He feels discomfort, weak, short of breath, sweaty, or dizzy. In ayurveda the arrhythmic conditions are mot much described, they are covered in the topic "Hridya gata roga" means a topic related to cardiac disease.

In modern sciences the anti-arrhythmic medicines are belonging to digitalis, beta-blockers, potassium and calcium channel blocker. In complicated cases the surgical intervention is required. The surgery and implantation are required as last stage of treatment.

Those drugs, which work by blocking the impulses, that may cause an irregular heart rhythm and by interfering with hormonal influences (such as adrenaline) on the heart's cells are called beta-blockers. They also maintains blood pressure and heart rate. Propranolol, metoprolol, and atenolol are examples of beta-blocker drugs.

The sodium-channel blockers are also helpful. They  have a tendency to slow down the electrical conduction in the heart. Quinidine, procainamide, disopyramide, flecainide, propafenone, tocainide, and mexiletine are some of the examples.

The medicines that slow down the electric impulses in the heart by blocking the its potassium channels are called potassium channel blockers. Amiodarone, sotalol, and dofetilide are some of the examples of potassium blockers.

Those categories of medicine that are blocking the calcium channels in the heart are called the calcium channel blockers. Diltiazem and verapamil are few of its example.

The digitalis category drugs are rarely used now.

The anti-arrhythmic drugs must be used very carefully and should be taken under strict medical observation as some times the conditions of a patient may get worsen due to these medicine. This condition is known as pro-arrhythmia.

Ayurveda describes the cardiac drugs as "Hridya". This category of drugs contains many medicines and herbs.

Following are the main drugs and medicines used as anti-arrhythymic drugs.

Hritapatri, ajamoda, lata kasturi, parushaka, draksha, katphala, dadim, rajadan, triphala, shakaphala, Amra, lakucha, amlavetas, badar, matulung and karmarda these are the cardiac tonics. Apart from these herbs, there are certain drugs that increase the contraction and expansion without increasing the heartbeat.

In ayurveda a class of drug is having the effect to strengthen the cardiac muscles they are jaharmohara and kaharva. Those medicines that have madhur (sweet) and amla (acidic) taste.

There are a number of preparations that can be used as cardiac tonics. These mineral preparations are lauha bhasma, abhraka bhasma, swarna bhasma, vacha, arjun, lajawarta, and praval.

The combination choorna that are used in this disease are –

Pippalyadi choorna, hingavadi choorna, mrigashringa choorna, nagabala choorna, kakubhadi choorna, pushkaramuladi choorna

The ghee based preparations like Arjuna ghrita, baladhya ghrita, madhuka, mahameda, shalparni.

Medicated milk arjun ksheer paak.

The decoction of devadaru, vacha, yavani palash, shunthi, abhya, udambur are also very helpful. Arjunarishta, balarishta and ikshurasa are used.

All these medicines have direct and parental effect on the arrhythmic conditions. These medicines have tendencies to effect the heart rate as well as soothes the effect on the muscles of heart.

Recent studies about garlic as anti arrhythmic drug shows that it has higher dehress of sulphur compounds. Garlic has anti-arrhythymic properties to reduce both types of arrhythmias. Though the mode of action is not defined the effects are observed. The ayurvedic medicines can be divided into-

In condition of Hridya daurabalya (Cardiac weakness) Nagarjunabhra Rasa, Muktapisti, Jwahar Mohra and Arjunarishta are very effective.

In Rakta Chap (Hypertension), Yogendra Rasa is considered the best.

In Raktabhar Alpta (Hypo tension), Makaradhvaja gutika, Kasturi bhairav Rasa are quite beneficial.

In Hritshoola (Angina), Sringa Bhasma, Mahavat Raj Rasa. There are rasa-based medicines like kalyan sundaer rasa, chintamani rasa, haridyarnava rasa, panchanana rasa, and prabhakar vati are commonly used.

Modern sciences the following medicines to be cardiac tonic- Arjuna (Terminalia arjuna) Kushtha (Saussurea lappa) Bala (Sida cordifolia) Hatapatri (Digitalis purpurea Foxglove) Rasona, (Garlic Allium sativum), Ashwagandha (Withania somnifera)

The very basic preventive method against this disease is to use a garlic, pomegranate, Arjuna powder, and avoid smoking alcohol.

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