Arrhythmia and Its Symptoms
An arrhythmia (also called irregular heartbeat) is a problem with the rate or rhythm of the heart. In an arrhythmia, the heart could either beat too fast, too slowly, or with an irregular pattern(1).
In healthy adults, the heart regularly beats at a rate of 60 to 100 times per minute(2). However, the sudden surge of stress, problems in the heart’s electrical signals, blood imbalance, and medicines may cause changes in the heart tissue, leading to arrhythmia(3).
Cardiac arrhythmias can be classified according to their effect on the heart rate, with bradycardia indicating a heart rate of fewer than 60 beats per minute and tachycardia indicating a heart rate of more than 100 beats per minute(4).
Tachycardia or fast heart rate is further subdivided into supraventricular and ventricular arrhythmias(5).
Supraventricular arrhythmia begins in the atrium (the heart’s upper chambers) or at the gateway of the lower chambers. In this case, the lower and upper chambers sometimes have uneven rhythms(6).
Atrial fibrillation (heart beats more than 400 per minute), atrial flutter (upper chambers beat 250 to 350 per minute), and paroxysmal supraventricular tachycardia (extra heartbeats caused by electrical signals in the upper and lower chambers) are the types of supraventricular arrhythmia(7).
On the other hand, the ventricular type of tachycardia is a regular but fast beating of the ventricles that may last for a few seconds(8). This type of tachycardia does not generally cause severe heart problems(9).
However, if ventricular arrhythmia lasts for longer than a few seconds, it may lead to a more dangerous condition, like ventricular fibrillation(10).
Ventricular fibrillation happens when an erratic electrical impulse makes the ventricles quiver instead of beating naturally. This type of arrhythmia may cause cardiac arrest or heart failure(11).
Symptoms of arrhythmias include(12):
- Fast or slow heartbeat
- Skipping beats or heart palpitations
- Lightheadedness or dizziness
- Chest pain
- Shortness of breath
Arrhythmias are often treated with a lifestyle change, like managing stress, maintaining a healthy weight, and being physically active(13).
Some doctors advise people to take anti-arrhythmic medications, like beta-blockers (to treat hypertension or high blood pressure), adenosine (to slow down heart rate), blood thinners (to avoid blood clots), and more(14).
CBD and Its Benefits
Cannabidiol (CBD) is one of the phytocannabinoids or naturally occurring components in a hemp plant(15). Hemp is a cannabis plant strain that has low THC but abundant CBD content(16).
CBD is non-psychoactive and non-addictive, unlike THC (tetrahydrocannabinol), which gives the euphoric effect(17). CBD oil is the typical form of CBD extract.
Phytocannabinoids (plant cannabinoids) interact with the human endocannabinoid system (ECS). The ECS has an important role in the development of the central nervous system (CNS), endogenous and environmental insults, and synaptic plasticity(18).
Although CBD and the ECS receptors, CB1 and CB2, do not significantly bind together, a study noted that CBD’s actions may be attributed to the inhibition of anandamide degradation or CBD’s antioxidant activity(19).
Anandamide is a fatty acid neurotransmitter that acts as a messenger molecule. It plays a role in pain, depression, memory, appetite, and fertility(20).
Research also suggests that CBD can induce protective effects that may help counteract the adverse effects of THC(21).
CBD is believed to have potential therapeutic benefits in treating various diseases and conditions(22).
Neuroprotective properties, chronic pain relief, anti-inflammatory properties, and anti-anxiety properties are among the purported benefits of CBD(23).
An animal study that examined CBD’s neuroprotective properties has noted that CBD may reduce both the number of viable neurons and degenerating neurons by 50% in newborn piglets that have hypoxia (a condition in which the body is deprived of adequate oxygen supply) and blockage of carotid arteries (hypoxia-ischemia)(24).
The same study also suggested that CBD administration may be linked to hemodynamic, cardiac, and ventilatory beneficial effects(25).
Another study on diabetic mice models showed that CBD treatment may reduce neurotoxicity, inflammation, and blood-retinal barrier breakdown(26).
CBD’s anti-inflammatory characteristics were highlighted in a study on human sebocytes (sebum-producing cells). Results suggested that CBD has potential benefits in the treatment of acne vulgaris(27).
Moreover, a study suggested that CBD may help with cardiovascular disorders by reducing oxidative stress, fibrosis, and cell death(28).
CBD and Arrhythmia: What Research Says
According to a study published in the British Journal of Pharmacology, drastic cannabidiol or CBD administration suppressed irregular heartbeat caused by ischemia-induced heart arrhythmias (inadequate blood supply in the heart) in an animal model(29). This result suggests that CBD may provide the heart with protection.
The study also noted that CBD reduced tissue death due to inadequate blood supply (infarction) before reperfusion(30).
The American Heart Association describes ischemia as a condition characterized by a restricted or reduced blood flow (which also restricts the flow of oxygen)(31).
In the same study, irregular heartbeats were monitored during ischemia before CBD perfusion periods (passage of fluid through the circulatory system).
The size of the infarct (a localized area of dead tissue) or obstructed blood supply and cell damage in the heart were also examined through the drawing of blood from the arteries(32).
The researchers also found the following:
- Cannabidiol reduced the incidence of irregular heartbeats caused by reduced blood flow or ischemia.
- CBD minimized the infarct or damaged tissue size when the cannabinoid was administered before ischemia.
- The effect of CBD was dose-dependent.
- CBD may help prevent ventricular arrhythmias, characterized by irregular heartbeat occurring in the heart ventricles or heart chambers.
According to an article published by the University of Rochester Medical Center, as a result of long-term stress, high cortisol blood levels can raise blood cholesterol, blood pressure, triglycerides, and blood sugar(33). These are the common risk factors for arrhythmia and other heart diseases.
Meanwhile, CBD has been shown to possess anti-anxiety properties that may help combat stress.
Published in Neurotherapeutics Journal, a 2015 review of 49 studies suggested CBD’s efficacy in reducing anxiety behaviors linked to multiple disorders(34).
In some cases that contribute to the development of ventricular tachycardia, open-heart surgery may be needed. An example of such a case is when there are blockages in the blood vessels(35).
After surgery or a heart attack, an individual may experience loss of appetite due to surgical pain, which can eventually lead to low levels of calcium and potassium, slowing down long-term recovery(36). Electrolyte imbalances can also make an individual susceptible to arrhythmia(37).
Fortunately, when it comes to pain relief, CBD may be useful. A study published in Chemistry and Biodiversity showed that a 1:1 ratio of CBD and THC helped with pain and sleep problems(38).
Meanwhile, results from a study, which examined the interaction between cannabinoids and cannabinoid receptors, showed evidence of how the endocannabinoid system can regulate appetite(39).
CBD’s potent anti-inflammatory properties were also demonstrated in a 2018 study published in the Journal of Pharmacology and Experimental Therapeutics(40).
Working directly with the cannabinoid receptors of the body to help suppress inflammation, CBD may help people with myocarditis experience pain relief and reduced signs and symptoms.
Side effects of CBD
Even though CBD has exhibited potential benefits for cardiovascular diseases, there are still risks to keep in mind when taking CBD.
Some of CBD’s known side effects include the following(42):
- Dry mouth
- Reduced appetite
Other side effects of CBD may also include nausea, stomach pain, or discomfort(43).
There are possible drug-to-drug interactions between CBD and other medications. CBD may increase or decrease the liver breakdown of some medications, leading to either an overdose or a lack of the desired medicinal effects(44).
First time CBD users are advised to start slow at a low dose of CBD. More importantly, a physician’s advice is recommended before using any CBD products.
Legality of CBD
The US Food and Drug Administration (FDA) has approved only one CBD infused drug, Epidiolex, used to treat severe forms of childhood epilepsy(45).
Epidiolex is an oral solution formulated to help with seizures associated with Lennox-Gastaut syndrome and Dravet syndrome(46).
According to the USFDA, the administration of this CBD-infused drug, along with other medications, has shown effectiveness in reducing seizure frequency(47).
Note that under the 2018 Farm Bill, industrial hemp derivatives with 0.3% or less THC content are federally legal in the United States(48).
However, different states in the US have specific regulations and stipulations regarding CBD products. It is advisable to research these laws to avoid unfortunate legal consequences.
Studies have begun to show some potential health benefits of CBD. This non-psychoactive cannabinoid from the cannabis plant may help prevent arrhythmia by providing its potential therapeutic properties.
However, side effects come with CBD use, such as possible interactions with drugs used to promote the health of the cardiovascular system.
According to Mayo Clinic, other possible side effects of CBD use include drowsiness, dry mouth, diarrhea, fatigue, and reduced appetite(49).
Thus, before using CBD or any CBD products (such as tincture, gummies, salves, patches, or lotions) as a supplement to an existing therapy or as a remedy for specific heart conditions arrhythmias, consult with a doctor experienced in cannabis use for advice.
- MedlinePlus. (2016, August 15). Arrhythmia. Retrieved from https://medlineplus.gov/arrhythmia.html.
- Harvard Health Publishing. (2019, Feb). Cardiac Arrhythmias. Retrieved from https://www.health.harvard.edu/a_to_z/cardiac-arrhythmias-a-to-z.
- NIH National Heart, Lung, and Blood Institute, (n.d.), Arrhythmia: Also known as Dysrhythmia, retrieved from https://www.nhlbi.nih.gov/health-topics/arrhythmia#:~:text=An%20arrhythmia%20is%20a%20problem,the%20condition%20is%20called%20bradycardia.
- MedlinePlus. (2016, August 15). Arrhythmia. Retrieved from https://medlineplus.gov/arrhythmia.html.
- NIH National Heart, Lungs, and Blood Institute, Op. Cit.
- Project CBD, (n.d.), What is CBD?, retrieved from https://www.projectcbd.org/about/what-cbd
- Congressional Service, (March 2019), Defining Hemp: A Fact Sheet, retrieved from https://fas.org/sgp/crs/misc/R44742.pdf
- Lu, H. C., & Mackie, K. (2016). An Introduction to the Endogenous Cannabinoid System. Biological psychiatry, 79(7), 516–525. https://doi.org/10.1016/j.biopsych.2015.07.028
- Pacher, P., Bátkai, S., & Kunos, G. (2006). The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacological reviews, 58(3), 389–462. https://doi.org/10.1124/pr.58.3.2
- Merriam-Webster Dictionary, (n.d.), Anandamide, retrieved from https://www.merriam-webster.com/dictionary/anandamide
- Niesink, R. J., & van Laar, M. W. (2013). Does Cannabidiol Protect Against Adverse Psychological Effects of THC?. Frontiers in psychiatry, 4, 130. https://doi.org/10.3389/fpsyt.2013.00130
- Konieczny, E., (2018), Healing with CBD, Chapter 5, pp. 110, retrieved from https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- Project CBD, Op. Cit.
- Alvarez, F. J., Lafuente, H., et. al., (December 2008), Neuroprotective Effects of the Nonpsychoactive Cannabinoid Cannabidiol in Hypoxic-Ischemic Newborn Piglets, retrieved from https://www.nature.com/articles/pr2008260
- El-Remessy, A. B., Al-Shabrawey, M., et. al., (January 2006), Neuroprotective and Blood-Retinal Barrier-Preserving Effects of Cannabidiol in Experimental Diabetes. Retrieved from https://www.sciencedirect.com/science/article/pii/S000294401062086X
- Olah, A., Toth, B. I., (July 2014), Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes, retrieved from https://www.jci.org/articles/view/64628
- Rajesh, M., Mukhopadyay, P. et. al., (December 2010), Cannabidiol Attenuates Cardiac Dysfunction, Oxidative Stress, Fibrosis, and Inflammatory and Cell Death Signaling Pathways in Diabetic Cardiomyopathy. Retrieved from https://www.jacc.org/doi/full/10.1016/j.jacc.2010.07.033
- Walsh SK, Hepburn CY, Kane KA, Wainwright CL. Acute administration of cannabidiol in vivo suppresses ischaemia-induced cardiac arrhythmias and reduces infarct size when given at reperfusion. Br J Pharmacol. 2010;160(5):1234–1242. DOI:10.1111/j.1476-5381.2010.00755.x.
- American Heart Association. (2015, July 31). Silent Ischemia and Ischemic Heart Disease. Retrieved from https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/silent-ischemia-and-ischemic-heart-disease.
- University of Rochester Medical Center Rochester. Stress Can Increase Your Risk for Heart Disease. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=2171.
- Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825–836. doi: 10.1007/s13311-015-0387-1.
- Mayo Clinic. (2018, Oct 4). Ventricular tachycardia. Retrieved from https://www.mayoclinic.org/diseases-conditions/ventricular-tachycardia/diagnosis-treatment/drc-20355144.
- Parham WA, Mehdirad AA, Biermann KM, Fredman CS. Hyperkalemia revisited. Tex Heart Inst J. 2006;33(1):40–47.
- Gettes LS. Electrolyte abnormalities underlying lethal and ventricular arrhythmias. Circulation. 1992;85(1 Suppl):I70–I76.
- Russo EB, Guy GW, Robson PJ. Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine. Chem Biodivers. 2007;4(8):1729–1743. DOI:10.1002/cbdv.200790150.
- Kirkham TC. Cannabinoids and appetite: food craving and food pleasure. Int Rev Psychiatry. 2009;21(2):163–171. DOI:10.1080/09540260902782810.
- Petrosino S et al. Anti-inflammatory Properties of Cannabidiol, a Nonpsychotropic Cannabinoid, in Experimental Allergic Contact Dermatitis. Journal of Pharmacology and Experimental Therapeutics June 2018, 365 (3) 652-663; DOI: https://doi.org/10.1124/jpet.117.244368.
- Mayo Clinic. (2019, Mar 16). Myocarditis. Retrieved from https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539.
- Bauer, B. (2018, Dec 20). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700.
- Medline Plus, (n.d.), Cannabidiol (CBD), retrieved from https://medlineplus.gov/druginfo/natural/1439.html
- USFDA, (June 2018), FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy, retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
- Congressional Research Service, Hemp Fact Sheet Op. Cit.,
- Bauer, B., Op. Cit.