Alternative Therapies in the Treatment of Cardiac Injury:

A Case Report with Recovery Regimens for Nonablatable Atrial Fibrillation and Greatly Enlarged Left Atrium

by Hans J. Kugler, PhD; with Ulrich Friedrichson, MD, PhD; Fouad Ghaly, MD; and Paul Ward, PED

Abstract

Two side-impact accidents left a 68-year-old patient with a damaged heart for which orthodox medicine had no treatment. This article details how the multifactorial approach (MFA) – combining key essential requirements for optimum health, with an emphasis on rebuilding the muscles of the heart and the revascularization of regenerated heart muscles – enabled the patient to achieve a full recovery.

Keywords

: multifactorial approach, alternative therapies, cardiac injury, left atrium, A-Fib

Anti-Aging Ther. 12:173–182. Proceedings of the 17th Congress of the American Academy of Anti-Aging Medicine; Las Vegas; Dec. 12, 2009. CD of talk available at: http://www.instatapes.com/A4M/toc.htm; disc 3, talk no. 2.

Introduction

Patient: 68-year-old Caucasian male, impact-induced (2 severe car accidents) atrial fibrillation (nonreversible; shock, chemical, ablation), left atrium 6.8 (<4.0 is normal), ejection fraction 28% (>50% is normal), 4/6 heart murmur. Besides “three drugs and a pacemaker/defibrillator,” mainstream medicine has no treatment protocol for such a patient, and absolutely none for a full recovery. Using the multifactorial approach (MFA) – combining key essential requirements for optimum health, with an emphasis on rebuilding the muscles of the heart and the revascularization of regenerated heart muscles –, we achieved a full recovery. Heart rhythm has been 100% sinus for 3 years now, ejection fraction 80%, left atrium 3.7 (normal again), and 1/6 heart murmur. The key alternative modalities that were combined included: resistance exercise (weight-lifting), organ-specific embryonic cell extracts (heart, mesenchyme, and muscle), EECP (enhanced external counter pulsation), small amounts of human growth hormone (HGH), meditation, breathing techniques, and a number of nutrients that are heart-specific and anti-inflammatory.

Addendum: 62-year-old male patient, extremely poor state of health (bronchitis, poor skin color, congestive heart failure, coronary artery disease, heart irregularities uncontrollable with pacemaker, ejection fraction 18%, on priority list for heart transplant) followed the same recovery protocol in two 4-months segments. He is now off the heart transplant list, his ejection fraction has nearly tripled, his pacemaker now effective, and he is “in good health with lots of smiles” back working on his farm, lifting bails of hay for weight-training exercises.

Alternative Therapies in the Treatment of Cardiac Injury: a Case Report

History

In October 2003, while not in motion, the patient’s car was impacted on the left by another car. ECG at the accident site had some unusual spikes and the paramedics suggested a follow-up with regular ECG. During the follow-up visit kidney contusion (blood in urine), severe back muscle spasms, and torn tissues in the left shoulder were diagnosed. Heart murmur (4/6) manifested itself a few weeks later. Initial treatment focused on severe muscle spasms and kidney damage. Patient was not put on muscle relaxants because of previous impact-induced heart injuries and atrial fibrillation (A-Fib). Doctor prescribed EECP plus a strong supplementation program.

About 2 years prior to the 2003 accident, the patient was involved in a severe multiple car accident that resulted (besides torn muscles and connective tissues, left shoulder dislocation, and twisted back) in a heart injury resulting in A-Fib, 28% ejection fraction (>50% is normal), left atrium 6.8 (<4.0 is normal). A literature search showed several cases of accident-induced A-Fib; one case pinpointed the car accident as the cause of the A-Fib 3 years after the accident. The A-Fib, which was irreversible with shock or chemical cardioversion, was ablated and the patient stayed in sinus rhythm and was recovering well up to the point of the second car accident.

Just prior to the October 2003 accident:

• An ECG was taken on 9.03.03 which was completely normal (sinus).

• No heart murmur was present.

• No history of chronic A-Fib or any related symptoms prior to the accidents.

• Passed aviation medical 4 weeks prior to the accident.

After the second car accident, the patient’s heart condition steadily declined over the next 1½ years. Starting with a “borderline” ECG (11/2003), mini ECGs (printouts while getting EECP treatments) kept deteriorating; heart murmur 4/6 (4 on a scale of 1-6) manifested itself. Various attempts to control A-Fib with single drugs (Coreg, amiodarone) failed; drug combinations were also ineffective. Cardioversion (08/2005) was unsuccessful; sinus rhythm held for only 3 days. Ablation (09.2005) was also unsuccessful; sinus rhythm held for only 5 days.

Following unsuccessful ablation, the patient was advised that nothing else could be done regarding reversing the A-Fib, 4/6 heart murmur, 28% ejection fraction, and left atrium 6.8. Examining doctors judged the second accident as far more serious than the first because of the additional heart murmur and unsuccessful ablation. Patient was advised: “3 to 4 drugs and a pacemaker/defibrillator for the rest of your life.”

The patient, who had research experience in the field of aging and the biomedical field, and having published studies based on the MFA to optimum health and longevity, was unwilling to accept defeat and, after three other opinions, consulted with various experts in cardiology and related fields regarding a possible recovery protocol.^1–8 The most basic advice – “think outside the box!” – required a closer look at what was inside the box, namely pharmaceutical drugs:

• US pharmaceutical drug consumption versus ranking of health worldwide:

  • 1976: Prof. E. Charskin, Alabama University School of Medicine: “U.S. outranked by some third world nations that can’t afford pharmaceutical drugs, but that have a climate for agriculture and livestock.”

  • 2005: John Abramson, MD, Harvard Medical School, writes that the drop in the US health system ranking (at this time 15th to 23rd worldwide) is inversely proportional to the tremendous increase in pharmaceutical drug consumption.⁹

  • 2008: Prof. Andrew Weil, MD, Arizona School of medicine: US now ranked no. 37 in the world – outdone by underdeveloped countries.

• No. 1 cause of death in the US is medicine itself; much of this is connected directly to pharmaceutical drug consumption.¹⁰

• Unnecessary prescribing of $15-plus billion of antidepressant drugs annually. Research suggests that depression is caused by a lack of physical activity, and that it can be classified as an exercise deficiency because it is easily treated with an exercise regimen that follows American College of Sports Medicine (ACSM) guidelines. In 2008 the antidepressant drug industry began to admit that treatment of depression is not very effective by recommending the addition of a second drug to treatment regimens. What kind of health care program would agree to people consuming billions of dollars worth of drugs (with potentially severe side effects, including thoughts of suicide) when a simple activity program can eliminate the problem?

• The effectiveness, or lack thereof, of HAART (highly active antiretroviral therapy) drugs. A study of 20,000 European and North American AIDS patients showed that taking these drugs for up to 1 year had zero effects on the death rate from AIDS, and that taking these drugs longer than 1 year actually increased the death rate from AIDS.¹¹ In the light of these data one can only suspect that the $60 to 100 billion drug company profits are the only reasons for keeping the “HIV causes AIDS” hypothesis alive.

These drug data bring to mind an Albert Einstein quote: “The definition of insanity is doing the same thing over and over again and expecting different results.”

Leaders in alternative and anti-aging medicine agree that “the regenerative power of a healthy body is immense.” According to Professor E Charaskin of Alabama School of Medicine, “health” is defined as a state of homeostasis, determined by at least 60 variables that can be grouped together as essential health practices, including exercise, nutrition, environment (toxins in the body), and stress management. He believes that combining these factors will produce synergistic effects on the overall state of health and recovery

The cardiac experts consulted agreed that the MFA could be the basis for a recovery program. In its most basic form, the MFA acknowledges that combining several positive single modalities will have a bottom-line synergistic effect. All of the modalities incorporated in the heart recovery protocol had previously been tried separately, and with some positive effects. Would combining them give the, synergistically enhanced, hoped for results?

There was also unanimous agreement among the cardiac experts that, for such a recovery protocol to be successful, the heart rhythm must get converted to sinus rhythm, and be kept in sinus rhythm, before the recovery protocol that focuses on rebuilding and strengthening the heart muscles could begin.

Recovery Protocol: The Major Modalities and Reasons for Employing and Combining Them

Cardioversion to restore sinus rhythm (and keep the heart in sinus rhythm) was the critical first stage of treatment. Once this was achieved the patient began the recovery program; this included:

• cell extracts: a refinement of Dr. Niehans Zelltherapie injectable (5 ml, i.m.), organ-specific extracts (contain low molecular weight peptides, nucleic acids, and growth factors) from embryonic sheep and porcine tissues, combined with oral cell extracts that are available in the US.¹² Injectable mesenchyme has been shown to increase healing, and heart extract has been shown to strengthen the heart and heart rhythms.^13,14 Ulrich Friedrichson, MD, PhD, reported that muscle extract has been shown effective in the recovery of muscle injuries, and in training and muscle development in athletes (personal communication, November 9, 2005).

• Super circuit weight training: Weight training has been shown to increase heart muscle in general, and build atrium walls specifically.^15–18 The weight-training exercise program used was designed by Dr. Paul Ward, PED, Olympic trainer.¹⁵

• EECP (enhanced external counter pulsation): Left atrium muscle needs to be revascularized if there is any hope of rebuilding it. EECP, besides greatly improving heart functions, has been shown to revascularize heart muscle.^19,20

• Niacin-based detox: Since rebuilding heart muscle is vital for recovery, estrogen effects and immune suppression, caused by exposure to BPA (bis-phenol-A) and other organic pollutant exposure from plastics was unacceptable. A niacin-based detox program (1½ g of nonflushing niacin taken one hour before inducing sweating) was therefore practiced 2 to 3 times per week.

• Human growth hormone (HGH): 6 mg/month of HGH was used to support for the above modalities.

• Meditation and optimum breathing techniques: There are numerous references in the scientific literature that show a connection with breathing and heart functions.^18,21

• Nutrition and nutritional supplements: A quality diet – with an emphasis on avoiding trans fats, high-fructose corn syrup, and chemical pollutants – was supported with blueberries, strawberries, and pomegranate juice/concentrate. A basic supplementation program as recommended by Melvyn Werbach, MD: consisting of B-complex, multiminerals, antioxidants, and extra niacin. ^22–27 In addition:

  • Fish oil: Biochemistry of lipid metabolism and anti-inflammatory action show a high priority for fish oil, later supported with data that showed a reduction of arrhythmias with fish oil.^28–30

  • Acetyl-carnitine: Increases the activity of cytochrome oxidase in the heart, and is thus important for mitochondrial energy metabolism.^31–33

  • Alpha-lipoic acid: Important for mitochondrial – high energy output – cell functioning.^34,35

  • L-Arginine: Metabolized to nitric oxide, a key factor in blood pressure regulation and exercise metabolism.^36–38

  • Turmeric: The curcumin in turmeric has a demonstrated anti-inflammatory effect, and has been shown to benefit the heart.^39,40

  • Vitamin D: Vitamin D deficiency, especially in the light of new (higher) vitamin D requirements, is a risk factor for heart health.^41–43

  • Coenzyme Q10: Protection from oxidative stress, and more, makes CoQ10 a key factor in metabolic therapy for heart disease.^44–46

  • Trimethylglycine (TMG): Decreases plasma homocysteine concentrations, increases oxygenation of tissues, and has a corrective effect on the nicotinamide coenzyme and adenine nucleotide content of the tissues.^47–49

There were two stages to the recovery program – an initial 3-month regimen, followed by a 5-month regimen.

3-Month Treatment Regimen

After chemical cardioversion (1.0 mg ibutilide IV), the patient adhered to the following regimen:

1. To keep the heart in the right (sinus) rhythm (at least for the first weeks of training) the patient took amiodarone and Coreg (carvedilol). Amiodarone: 600 mg/day, reduced to 400 mg/day after 2-weeks, 200 mg/day after 6-weeks, and 0mg/day after 8-weeks. Coreg: 12 mg/day – steadily decreased to 0 mg/day by 3 weeks.

2. Biochemical growth factors and nutritional support:

   1. Cell extract injections: 3 per week – alternating mesenchyme, heart, muscle.

   2. HGH: 5 mg/month, cycling – 1 unit/day for 3-days, then 3-days off.

   3. Overall quality nutrition: Including pomegranate extract, strawberries and blueberries, and a basic supplementation program (B-complex, multi-minerals, antioxidants, niacin). In addition special nutrients: fish oil (4 softgels, 1200 mg each, b.i.d.), acetyl carnitine (2× 1000 mg/day), arginine (2× 2,000 mg/day), turmeric (2× 2500 mg/day), vitamin D3 (3000 IU/day if 30 minutes of full body sun exposure was possible, otherwise 2× 5000 IU/day), CoQ10 (2× 120 mg/day), alpha-lipoic acid (800 mg/day), TMG (1000 mg/day).

1. EECP treatment twice per week.

2. Super circuit weight training: At start 3 times/week. 30 minutes each time. Pulse rate in lower range of [60%–80% of (220 minus age)] maximum. Duration of exercise sessions was increased by 15 minutes each week, to a total work-out period of 2 hours (3 times/week). Heart rate: increase 5 points/week up to a maximum of 110–115. Training supported with long walks and horseback riding.

3. Emphasis on meditation, breathing techniques.

Results

Heart rhythm was 100% sinus during the entire 3-month period. Heart murmur had decreased to 1 to 2 by the end of the 3-month period. Echocardiogram confirmed recovery success: ejection fraction 60% (up from 28%), left atrium 5.8 (down from 6.8, normal is <4.0), and all other variables in normal range. Patient felt extremely good; exercise capacity is back to near preaccident level, including jogging, weight-lifting, and horseback riding.

5-Month Follow-Up Regimen

Since EECP and the cell extracts at the treatment level were quite expensive, these two treatment modalities had to be greatly reduced; the recovery regimen (as above) was continued with only one EECP session and one cell extract per week. The cell extracts were gradually reduced and replaced with two types of oral cell extracts: liquid (mesenchyme and thymus, alternating, at a frequency of three 6 ml vials per week) and tablets (15 tablets 2 times/day). These adjustments did not change cardiac performance/output.

After 3-months on this reduced treatment regimen, EECP frequency and injections of the embryonic cell extracts were further reduced to 1 every 2 weeks, and were discontinued after the 4th month. All other modalities, oral cell extracts, health practices, nutritional support, and special supplements, were continued as before, for a total of 5 months.

Results

Echocardiogram after the 5-month recovery protocol showed further improvements: ejection fraction 80%, left atrium further improved to 3.7 (now in normal range), and all other variables within normal ranges. Routine examinations, besides confirming the excellent state of health, also recorded a further decrease in the heart murmur to 1-2/6. Patient felt very good, and was maintaining a strong health and fitness approach. Patient had lost 18 lbs of lean body mass in the time following the 2003 accident. However, by following the super-circuit weight training, as developed by Ward, he had managed to regain 12 lbs of lean body mass by December 7.¹⁴ ECG, blood analysis, and regular examinations have shown him to be fully recovered and in excellent health (also passed two aviation medical examinations).

Addendum

62-year-old male patient in extremely poor state of health – bronchitis, skin color waxy, pale, blood pressure 140/110, edema of lower extremities (2+ mid calf), reduced lung capacity (rhochi and rales), greatly reduced heart capacity (ejection fraction 18%, severe heart irregularities, uncontrollable with pacemaker), on priority list for a heart transplant – followed the above recovery program in two 4-month stages.

Patient’s health is greatly improved: good skin color, echocardiogram shows a near tripling of ejection fraction, heart rhythm now controllable with pacemaker, off the heart transplant list, is “in good spirits, with lots of smiles,” working on his ranch again, and lifting hay bales as exercise.

Discussion

In previous research projects the MFA yielded excellent results in longevity studies on cancer-prone animals, in the reversal of two prostate cancer case histories, and in longevity studies on humans.^5–8,50,51 In the heart recovery described above, several of the modalities used had previously been used separately, with good indications. When, after the 2003 accident, all of these modalities were combined correctly, real success was achieved.

An explosion of data, demonstrating the importance of key nutrients in respect to heart health, was published previous to the time when our recovery protocol was designed; some data regarding the importance of these nutrients came from “the horses mouth” even before they were published, and that also included data regarding correct dosages. A good example is vitamin D. After becoming aware of ongoing research that linked vitamin D and heart health, the dose was increased to effectively 7000 IU/day (including the sunshine-produced vitamin D). Another example is fish oil, which was originally used at a dosage of 2000 mg/day, was increased to 10 g/day, after becoming aware of data that showed great reductions in arrhythmias and even atrial fibrillation with fish oil use. Similar reasoning led to a reduction in vitamin E (from 400 IU/day to the 100 IU contained in the basic vitamin and mineral supplement).

With high energy-output cells, like those of the heart, mitochondrial functioning is essential – that is why acetyl-carnitine and alpha-lipoic acid were included in the regimen. Besides the references quoted above, a PubMed search for “mitochondrial functioning and heart” will yield nearly 100 references.

Regarding the supplements and other modalities like EECP, cell extracts, and weight-training, we stayed on the aggressive side because we were dealing with a serious condition and many experts pointed out that (in their opinion) our chance for success was minimal or nonexistent; thus we thought that we had to take our chance with truly aggressive levels. It is important to note that for every modality used and increased to maximum levels, we explored the literature (and consulted experts) to evaluate if the suggested level could do any harm; only when the answer to this question was a clear “no,” then the aggressive level was followed. This was one of the reasons why HGH was kept at a lower level.

Can we answer the question, what specifically made this protocol successful? The answer is clear: Synergism via the MFA. Each modality that was incorporated had good science supporting its use – when used in combination, the modalities enhanced each other. The patient’s true belief also impacted the effectiveness of all the supplements and modalities – that this would be a success, with consistent visualizing of (1) optimum health, (2) passing aviation medicals, and (3) flying bigger and faster airplanes. In essence, he planned tomorrow as if there were no problems at all today; all of his future and specific goals that required health and delivered happiness were seen and felt as a fait accompli.

There was one key point of observation, a profound state of feeling well and recovered, which the patient termed “achieved homeostasis.” He kept a record of how it felt immediately after applying specific modalities, and his notes showed that this feeling of “achieved homeostasis” followed the day when he took cell extracts or EECP, and the second day after weight lifting in the gym. Breathing techniques, combined with meditation, were also high on the list of modalities that contributed to the feeling of “achieved homeostasis.”

The successful recovery of another heart patient gave additional credence to the overall program

Our lasting results point towards the need for research in several areas: After an ablation there is a period of “burning in the circuits,” and drugs like amiodarone (even though with numerous negative side effects) are quite effective in achieving success. Present ablation success rates are 70% to 80%. Future research needs to find out which of the modalities that we used are helpful in burning in the circuits, and which ones are effective in giving lasting results.

Mainstream medicine also has no recovery protocol for a severely enlarged left atrium; most likely, the great enlargement of the left atrium was due to an injury incurred during the accident and the delay in diagnosis/treatment. This area looks most promising for future research; since all the modalities that were used in our recovery program are non-drug, and carry no risk for subjects, even the most basic research protocol would quickly pinpoint priorities and the degree of effectiveness of the modalities used.

The need for more research is underlined again with initial findings (follow-up observations by Fouad Ghaly, MD) that suggest greater improvements in heart functions when a patient is given a choice to combine EECP with any one, or more, of the alternative modalities discussed above.

In retrospect, we wondered why, after the first accident, it took more than one year to diagnose A-fib. Examinations usually took place in the morning. The night before patient took 5-HTP and GABA (gamma amino butyric acid) for better sleep. GABA is chemically related to the cardioversion drug ibutilide. GABA can also hydrolyze in the body, via a nucleophilic substitution reaction, to GHB (gamma hydroxybutyric acid), which has a strong sedative effect. Could GABA have slowed down heart rhythm (possibly in sinus) in the morning when examinations usually took place?

Contacts

Hans Kugler, PhD: drkugler1@verizon.net

Fouad Ghaly, MD: dr_fghaly@yahoo.com

Ulrich Friedrichson, MD, PhD: info@friedrichson.de

Paul Ward, PED: lion1@ix.netcom.com

Notes

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