Vitamin C as a treatment for AF

my name is sanjay gupta i'm a cardiologist in york and i believe that high quality evidence-based jargon-free information about health should be available to everyone at no cost and this is why i started this channel and today i wanted to talk to you about a condition called atrial fibrillation and in particular a natural supplement that is commonly available that may potentially benefit those patients who have atrial fibrillation so let's get started atrial fibrillation is a common heart rhythm disturbance which may impact on both quality and quantity of life atrial fibrillation can also come and go and when a patient does develop episodes of atrial fibrillation they can be very symptomatic with palpitation breathlessness fatigue and tiredness we also know that af begets af the more af you get the more you will have in the future now whilst there are many pharmaceutical agents that may be used to reduce the burden of af in these patients these medications are often associated with side effects and can also be very costly and therefore it's not surprising that patients would prefer natural alternatives the problem is that most of modern medical practices driven by the pharmaceutical industry who would never fund a study large enough to study a natural agent and therefore the common argument against using a natural supplement would be that there is lack of evidence of course there's lack of evidence because no one will do the experiments because it's all about money at the end of the day and no one's going to make any money out of a natural supplement and so i have become increasingly interested in seeing if there are any small scale studies which show any benefit from natural supplements on both af occurrence and af recurrence and this is where i chanced on some research on the potential benefits of vitamin c in af which i will share with you today now we know that there is a process called oxidative stress and i have to admit i don't fully understand this which has been implicated in both the pathogenesis and the perpetuation of af it would therefore seem reasonable to hypothesize that all those agents that may have antioxidant properties could perhaps benefit patients with af because they're acting against oxidative stress now vitamin c is one such naturally occurring potent water-soluble antioxidant and in 2001 a group of researchers led by a scientist called cynthia khans became interested in the antioxidant effects of vitamin c and they wanted to study the effects of vitamin c on the atria the atrial the chambers that tend to malfunction in atrial fibrillation and what they did was they did an animal based experiment where they took 11 dogs and what they did was they put a wire in the atria and delivered electrical impulses at a very fast rate 400 beats per minute to these atria so they were stimulating these atria at 400 beats per minute to try and mimic af and then what they wanted to do is they wanted to study the effects of this on the electrics within the atria they were particularly interested in something called the atrial effective refractory period which is the time when the heart muscle is refractory to any new electrical signals if this period is shortened then it increases the likelihood of more heart rhythm irritability af etc and what this group of scientists found is that pacing the atria at a very high heart rate was associated with two things a a shortening in this atrial effective refractory period making it more likely that the heart becomes more irritable and a fall in ascorbic levels in the tissue and what they found was that if you supplemented these dogs with extra ascorbate vitamin c beforehand then you did not see this shortening in the atrial effective refractory period meaning that in some way supplementation with vitamin c protected against more atrial electrical irritability these authors then became interested in these findings and decided to do a study on patients and they took 50 patients who'd be planned to have a heart bypass operation and they gave them two grams of extended release ascorbic acid the night before surgery and they followed this up with 500 milligrams twice a day for five days of vitamin c after surgery and they compared this group of patients with a group of aged match controls and they found something really interesting they found that the group of patients who were given the vitamin c had significantly less af in the post-operative period compared to the group that hadn't been given the vitamin c the difference was almost double so 16.3 percent of patients in the vitamin c group developed af in the post-operative period whereas 34.9 in the control group developed af in the post-operative period now this was a small study there were some flaws in this very small study so it's not possible to say okay well that's it it works but it was clearly very interesting that this natural supplement which is well tolerated does not have much in the way of side effects could be potentially associated with less af in this group of patients there was another interesting study then in 2007 by a scientist called else islami islami and this particular scientist wanted to study the effects of ascorbic acid in combination with beta blockers compared to beta blockers alone in patients undergoing heart surgery and they studied 100 patients and they found that indeed the incidence of af in the vitamin c group the group who had beta blockers and vitamin c was four percent and in the control group the group that only had the beta blockers without the vitamin c was 26 so substantially less af in the group that received the vitamin c in 2010 there was another author pat pulidus who published a paper showing that after bypass the incidence of af hospitalization time icu time and time interval for conversion back to a normal heart rhythm was significantly lower in the vitamin c supplemented patients in 2011 there was a scientist called harling who looked at all the data pertaining to vitamin c and he put it all and he performed this meta-analysis and he found that when you put everything together the data indicate that vitamin c supplementation does significantly reduce the amount of postoperative af although he admitted that the quality of the studies so far had been poor and therefore he felt that a bigger better design study was warranted before incorporating vitamin c into routine practice this is a specific group of patients patients who've had cardiac surgery is there any evidence about vitamin c in patients in the non-cardiac surgery setting who have af right and there are very few data but there's an interesting paper that was published in 2005 by an a greek author called coronation poulos and he published a study looking at the effects of vitamin c supplementation to see if it reduces the recurrence of af who in patients who have to undergo electrical shock treatment or cardioversion and he found that within one week af recurred in 36.3 of patients in the control group and only in 4.5 of the patients in the vitamin c group he also found that the inflammatory markers in the vitamin c group decreased compared to the control group so clearly this is very interesting data and this data makes a compelling case for studying this naturally occurring cheap generally very safe supplement the only problem is who is going to do this study and in the absence of a big study patients may continue to be deprived of an agent which may potentially make a significant difference to them because most doctors these days tend to be protocol driven rather than patient driven and this is where i think patient empowerment comes in this is where patients can come together and say look i understand there are gaps in the evidence base but this is generally a safe product and therefore maybe i am willing to try it and see how it goes i hope you found this video useful if you've had positive experiences vitamin c or negative experiences with vitamin c then this would be a great place to share your experiences in this way patients tend to benefit from each other rather than being at the mercy of pharmaceutical companies economists and protocol bound medics so i hope you found this useful i'm sorry i haven't put a video out for a long time my father's been unwell again i'm now back in kenya looking after him so it's all been a very stressful time for me and my family and that has translated into putting less videos out hopefully we'll get things right hopefully my dad will get better again and i'll continue to put some more videos out so once again thank you so much for all the support you give me i really appreciate it bye you

Channel: York Cardiology

Views: 303,095

Keywords: Heart palpitations anxiety, Heart palpitations after eating, Heart palpitations causes, Heart palpitations symptoms, Heart palpitations treatment, Heart palpitations cure, Ventricular ectopics, Heart disease symptoms, Heart racing, Heart flutter causes, Heart palpitations at night, AF, Afib, atrial fibrillation, natural supplements, Vitamin C, ascorbic acid, anti-oxidants

Id: pKBOAMmyzZI

Length: 10min 1sec (601 seconds)

Published: Wed Mar 10 2021