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Tachycardia is an abnormally rapid beating of the heart, defined as a resting heart rate of over 100 beats per minute. more...

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It can have harmful effects in two ways. First, when the heart beats too rapidly, it performs inefficiently (since there is not enough time for the ventricles to fill completely), causing blood flow and blood pressure to diminish. Second, it increases the work of the heart, causing it to require more oxygen while also reducing the blood flow to the cardiac muscle tissue, increasing the risk of ischemia and resultantly infarction.

Tachycardia is a general symptomatic term that does not describe the cause of the rapid rate. Common causes are autonomic nervous system or endocrine system activity, hemodynamic responses, and various forms of cardiac arrhythmia.

Autonomic and endocrine causes

An increase in sympathetic nervous system stimulation causes the heart rate to increase, both by the direct action of sympathetic nerve fibers on the heart, and by causing the endocrine system to release hormones such as epinephrine (adrenaline) which have a similar effect. Increased sympathetic stimulation is usually due to physical or psychological stress (the so-called "fight or flight" response), but can also be induced by stimulants such as amphetamines.

Endocrine disorders such as pheochromocytoma can cause epinephrine release and tachycardia independent of the nervous system.

Hemodynamic responses

The body contains several feedback mechanisms to maintain adequate blood flow and blood pressure. If blood pressure decreases, the heart beats faster in an attempt to raise it. This is called reflex tachycardia

This can happen in response to a decrease in blood volume (through dehydration or bleeding), or an unexpected change in blood flow. The most common cause of the latter is orthostatic hypotension (also called postural hypotension), a sudden drop of blood pressure that occurs with a change in body position (e.g., going from lying down to standing up). When tachycardia occurs for this reason, it is called postural orthostatic tachycardia syndrome (POTS).

Tachycardic arrhythmias

An electrocardiogram tracing can distinguish several different forms of rapid abnormal heartbeat:

If the heart's electrical system is functioning normally, except that the rate is in excess of 100 beats per minute, it is called sinus tachycardia. This is caused by any of the factors mentioned above, rather than a malfunction of the heart itself.

Supraventricular tachycardia (SVT) occurs when an abnormal electrical impulse originates above the ventricles, but instead of causing a single beat and a pause, it travels in circles and causes many rapid beats. To distinguish SVT from Sinus Tachycardia one must simply look at the rate: If the rate of contraction is more than 150 bpm, then it is considered SVT. Otherwise it is Sinus Tachycardia. Ventricular tachycardia (VT or "V-tach") is a similar phenomenon occurring within the tissue of the ventricles, causing an extremely rapid rate with poor pumping action. Both of these rhythms normally last for only a few seconds (paroxysmal tachycardia), but if VT persists it is extremely dangerous, often leading to ventricular fibrillation.


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The treatment of sinus tachycardia as a result of antipsychotic drugs with Chinese Medicine - Chinese Medicine Update
From Townsend Letter for Doctors and Patients, 5/1/02 by Bob Flaws

Keywords: Sinus tachycradia, antipsychotic drugs, Chinese medicine, Chinese herbal medicine, Tian Wang Bu Xin Dan

Liang Xiao-chi of the Guangdong Maoming Municipal Hospital for the Prevention & Treatment of Chronic Diseases recently published an article titled, "A Survey of the Treatment Efficacy of Tian Wang Bu Xin Dan (Heavenly Emperor Supplement the Heart Elixir) in the Treatment of Sinus Tachycardia as a Result of Antipsychotic Drugs." This article appeared in issue #11, 2001 of Xin Zhong Yi (New Chinese Medicine) on pages 30-31. Below is an abstract of that article.

Cohort Description

One hundred-two patients with sinus tachycardia as a result of the administration of antipsychotic drugs were studied by the author in 1998-1999. All these patients were seen as in-patients, all were examined with EKG, chest x-rays, liver function tests, kidney function tests, abdominal ultrasound, and blood analysis which were all normal before administration of the antipsychotic drugs. Patients with organic heart disease and those with serious physical diseases were excluded. One week after beginning the use of antipsychotic medications, such as chlorpromazine (Thorazine), these patients were given a repeat EKG and found to have sinus tachycardia with a heart beat of 120 BPM or more. In addition, all 102 patients manifest a pattern of yin vacuity with fire effulgence.

These 102 patients were then divided into two groups, a so-called treatment group and a comparison group. In the treatment group, there were 60 patients, 35 men and 25 women aged 17-58 years old. The longest history of psychoses was 11 years and the shortest was two months. Forty-three cases had simple sinus tachycardia, six had accompanying T-wave abnormalities, three had accompanying ST-T abnormalities, two had accompanying arrhythmias, etc. In the comparison group of 42 patients, there were 27 men and 15 women who ranged in age from 52-20 years of age and had a history of psychoses from 13 years to half a month. Thirty-three of these cases had simple sinus tachycardia, four had accompanying T-wave abnormalities, two had accompanying ST-T abnormalities, one had accompanying heart arrhythmia, etc. Therefore, in terms of age, sex, disease course, and EKG, there was no significant statistical difference between these two groups (P, 0.05)

In terms of the criteria for their Chinese medical pattern discrimination, after taking antipsychotic medications, these patients exhibited heart palpitations, heart fluster, a dry mouth and tongue, heart vexation, reduced sleep, heat in the hands, feet, and heart (or heat in the hearts of the hands and feet), constipation, a red tongue with scanty fluids, and a fine, rapid pulse. Their Chinese medical disease diagnosis was heart palpitations.

Treatment Method

Tian Wan Bu Xin Dan manufactured by the Guangdong Yang Jiang Drug Manufactory was administered orally to the treatment group. This ready-made medicine consisted of undisclosed amounts of: Semen Zizyphi Spinosae (Suan Zao Ren), Semen Biotae Orientalis (Bai Zi Ren), Tuber Asparagi Cochinensis (Tian Men Dong), Tuber Ophiopogonis Japonici (Mai Men Dong), uncooked Radix Rehmanniae (Sheng Di), Radix Scrophulariae Ningpoensis (Xuan Shen), Radix Panacis Ginseng (Ren Shen), Radix Salviae Miltiorrhizae (Dan Shen), Radix Platycodi Grandiflori (Jie Geng), Cinnabaris (Zhu Sha), Fructus Schisandrae Chinensis (Wit Wei Zi), Radix Polygalae Tenuifoliae (Yuan Zhi), and Sclerotium Poriae Cocos (Fu Ling). One pill of undisclosed weight was administered each time, three times per day.

The comparison group was orally administered 10-20mg of propanolol (Inderal) three times per day.

Treatment Outcomes

Cure was defined as disappearance of the clinical symptoms, a normal EKG, and a heart rate of 70-100 BPM. Marked effect as defined by decrease in clinical symptoms and a heart rate of 100-110 BPM. No effect meant that there was no improvement in clinical symptoms and that the heart rate as 120 BPM or higher. Based on these criteria, in the treatment group, 38 cases (63.33%) were judged cured, 15 (25%) experienced a marked effect, and seven (11.67%) got no effect, for a total amelioration rate of 88.33%. In the comparison group, 28 cases (66.67%) were judged cured, 12 (28.57%) got a marked effect, and two (4.76%) got no effect, for a total amelioration rate of 95.24%. Therefore, although propanolol achieved a better overall amelioration rate, there was no significant difference in cure rates between these two group. In addition, Tian Wan Bu Xin Dan did achieve a better treatment effect in terms of dry mouth, constipation, profuse sweating, heart vexation, and profuse dreams. The Chinese medicinals were able to achieve a 90% amelioration rate in terms of reducing these symptoms, while propanolol showed no obvious similar effect.


According to Dr. Liang, in Chinese medicine, the constellation of symptoms of heart palpitations, heart fluster, dry mouth, dry throat, heart vexation, reduced sleep, heat in the hands, feet, and heart, and constipation are most typically due to heart yin vacuity with vacuity heat harassing the spirit. The disease causes and disease mechanisms of this condition are mostly systemic yang exuberance consuming and damaging yin fluids or systemic yin vacuity. Either of these may lead to vacuity heat being engendered internally. Hence this situation is categorized as a root vacuity and a tip or branch repletion condition. Due to heart yin vacuity, the heart loses its moistening and nourishment. This results in heart palpitations and heart fluster, while vacuity heat harassing the heart spirit above causes heart vexation and reduced sleep. Heart fire hyperactivity and exuberance burning and damaging yin fluids results in dry mouth, parched throat, and constipation. The signs of a red tongue with scanty fluids and a fine, rapid pulse all are indications of yin vacuity and fire effulgence. Therefore, treatment should enrich and nourish heart yin to secure the root and clear heat and quiet the spirit to treat the tip or branch.

Within this formula, Sheng Di, Xuan Shen, Tian Men Dong, and Mai Men Dong enrich yin, engender fluids, and clear heat, thus promoting the increase of fluids and the free flow of the stools. Dang Gui and Dan Shen supplement the blood and nourish the heart. Ren Shen and Fu Ling boost the qi and calm the heart. Suan Zao Ren, Bai Zi Ren, and Yuan Zhi nourish the heart and quiet the spirit. Dang Gui, Suan Zao Ren, and Bai Zi Ren also moisten the intestines and free the flow of the stool. Wu Wei Zi restrains and contains the heart qi and quiets the heart spirit. Jie Geng leads the other medicinals in this formula to move upward in order to free the flow of the heart qi. When all these medicinals are used together, they have the effects of enriching yin and clearing heat, nourishing the heart and quieting the spirit.

This study is yet another example of how Chinese medicinals can be used to treat the adverse reactions of a Western medication and particularly of psychotropic medicines. This study also shows that the methodology for using Chinese medicinals in this way is nothing other than doing a Chinese medical pattern discrimination of the patient while on the Western medication and then treating the pattern(s) identified in the standard Chinese medical way.

For more information on the Chinese medical treatment of the side effects of Western psychotropic medicines, see Bob Flaws & James Lake's Chinese Medical Psychiatry available from Blue Poppy Press.

COPYRIGHT 2002 The Townsend Letter Group
COPYRIGHT 2002 Gale Group

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