Arrhythmia, irregularity in the rhythm of myocardial contractions, causes troubles for patients and is potentially life threating. 

Already in 2008, the review of available eight controlled clinical trials was published and it concluded that 87% to 100% patients, after the acupuncture treatment, returned to their normal sinus rhythm, what confirms that acupuncture is an effective method of treatment in at least some cases of arrhythmia(source)1.

The outcomes of recently published trial indicate, as well, the efficiency of acupuncture in preventing the recurrence of atrial fibrillation in patients after electric cardioversion(source)2 In this trial, the effectiveness of acupuncture was similar to the efficiency of pharmacotherapy with Amiodaron (35% recurrences in the group undergoing acupuncture treatment and 27% in the group of Amiodaron) and significantly larger than in control group (54% recurrences), as well as in the group with sham acupuncture (69% recurrences)

There were reports in literature that electroacupuncture may disturb functioning of pacemakers(source)3 , albeit the case of a patient from Greece was reported too, in which electroacupuncture turned out to be a safe intervention(source)4.

Heart rate variability (HRV) is the essential parameter connected with heart beat. In earlier reviews it was difficult to say anything explicit about the impact of acupuncture on this particular parameter(source)5, but three years ago, after inclusion of further clinical trial results, the role of acupuncture in its improvement was confirmed(source)6

STRENGTH OF EVIDENCE
Power of arguments
Arythmia - mechanisms

Scientists at the University of California have recently published extremely interesting analysis of molecular mechanisms explaining anti-arrhythmic activity of acupuncture(source)7. The authors meticulously described the outcomes of numerous experiments carried out on animal models, presenting detailed image of neuronal connections responsible for acupuncture impact on both premature systoles caused by the stimulation of hypothalamus, and on bradycardia caused by the stimulation of vagus nerve.  

Acupuncture prevents the recurrence of atrial fibrillation in patients after electric cardioversion:

Recurrence:

The mechanism of premature systoles is complex. Acupuncture using Pe-6 point, located over the median nerve, or using ST-36 located over the deep popliteal nerve, causes the stimulation of neurones in the arcuate nucleus of hypothalamus and in the ventral region of periaqueductal grey matter (vPAG), that results in the activation of neurons in raphe nuclei. Neurons from raphe nuclei impede the sympathetic centre in the area of rostral ventrolateral medulla (rVLM) by mean of serotonin and GABA. What is more, it was proved than there are direct neuronal connections between raphe nuclei and rostral ventrolateral medulla, which impede its functioning with the use of opioids. The influence on rVLM allows for heart beat balancing, preventing premature systoles.

In case of bradycardia, acupuncture using GB-37 or stimulation of superficial popliteal nerve causes the activation of neurons in the area of rVLM, which- in turn- thought the mediation of endogenou opioids and GABA impede the post-synaptic neurons (baroreceptor-sensitive)  in dorsal nucelus of vagus nerve (DVN) and ambiguous nucleus (NA),  and that in turn lowers the activity of vagus nerve and -as a result- bradycardia

Sham acupuncture

Control

Acupuncture

Amiodaron

BIBLIOGRAPHY

1 VanWormer AM, Lindquist R and Sendelbach SE. „The effects of acupuncture on cardiac arrhythmias: a literature review.” Heart Lung 37 (2008): 425-431.

2 Lomuscio A, Belletti S, Battezzati PM, Lombardi F. „Efficacy of acupuncture in preventing atrial fibrillation recurrences after electrical cardioversion. Journal of cardiovascular electrophysiology”. Mar 2011;22(3):241-247

3 Fujiwara H, Taniguchi K, Takeuchi J, Ikezono E: „The influence of low frequency acupuncture on a demand pacemaker.” Chest 1980; 78:96-97.

4 Vasilakos DG, Fyntanidou BP: „Electroacupuncture on a patient with pacemaker: a case report”. Acupunct Med 2011; 29(2):152-3.

5 Lee S, Lee MS, Choi J-Y, Lee S-W, Jeong S-Y, Ernst E. „Acupuncture and heart rate variability: a systematic review.” Auton Neurosci. 2010;155:5-13

6 Anderson B, Nielsen A, McKee D, Jeffres A, Kligler B. „Acupuncture and heart rate variability: a systems level approach to understanding mechanism.” Explore (NY). 2012 Mar-Apr;8(2):99-106.

7 Li P, Tjen-A-Looi SC. „Mechanism of the inhibitory effect of electroacupuncture on experimental arrhythmias.” J Acupunct Meridian Stud. 2013 Apr;6(2):69-81

THE AUTHOR