Effects of Acupuncture on Cardiac Remodeling in Patients with Persistent Atrial Fibrillation: Results of a Randomized, Placebo-Controlled, Patient- and Assessor-Blinded Pilot Trial and Its Implications for Future Research.

Jung Myung Lee,Jun Hyeong Park,Jimin Park,Weon Kim,Jungtae Leem,Hyung Oh Kim,Jong Shin Woo,Seung Min Kathy Lee,Suji Lee,Sanghoon Lee,Hyemoon Chung,Jin-Bae Kim,Woo-Shik Kim

doi:10.3390/medicina58010041

Jung Myung Lee, Jun Hyeong Park + Show 11 more

Open Access

https://doi.org/10.3390/medicina58010041

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Abstract

Background and Objectives: In this study, we attempted to determine the effects of acupuncture on cardiac remodeling and atrial fibrillation (AF) recurrence rates in patients with AF after electrical cardioversion (EC). Materials and Methods: We randomly assigned 44 patients with persistent AF to an acupuncture group or a sham acupuncture group. An electroacupuncture treatment session was administered once weekly for 12 weeks at four acupuncture points (left PC5, PC6, ST36, and ST37). Results: Among the 44 recruited participants, 16 (treatment group) and 15 (control group) completed the trial. The three-month AF recurrence rate (primary outcome) was not significantly different between the two groups. Following the completion of treatment, patients who had been treated with acupuncture had a significant reduction in left atrial volume index (42.2 ± 13.9 to 36.1 ± 9.7 mL/m2; p = 0.028), whereas no change in atrial size was observed in the sham acupuncture group. No serious adverse events were observed. The AF recurrence rate and cardiac function did not differ significantly between the two groups. At three months, the acupuncture treatment group showed more favorable atrial structural remodeling compared to the sham acupuncture group. Conclusion: In future research on acupuncture in AF management, it is recommended that the inclusion criteria be amended to include only symptomatic AF, that an appropriate control group is designed, and that the acupuncture treatment frequency is increased to several times per week.

Highlights

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and is the most frequent cause of cardiac embolic stroke [1,2]
Forty-four patients who were resistant to two weeks of flecainide therapy were randomized into active or sham acupuncture groups (22 patients in each group) at a ratio of 1:1 by central randomization
Transesophageal echocardiography (TEE) was performed just before electrical cardioversion (EC) to rule out atrial thrombus

Summary

Introduction

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and is the most frequent cause of cardiac embolic stroke [1,2]. Management of AF is difficult because of the limited efficacy and safety of current antiarrhythmic drugs, as well as the high recurrence rate of AF after radiofrequency catheter ablation. A recent randomized trial showed that the recurrence rate of AF after single radiofrequency catheter ablation was high, in patients with persistent AF [3]. We attempted to determine the effects of acupuncture on cardiac remodeling and atrial fibrillation (AF) recurrence rates in patients with AF after electrical cardioversion (EC). Results: Among the 44 recruited participants, 16 (treatment group) and 15 (control group) completed the trial. Following the completion of treatment, patients who had been treated with acupuncture had a significant reduction in left atrial volume index

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Results

Conclusion