Shensongyangxin Capsules for Paroxysmal Atrial Fibrillation: A Systematic Review of Randomized Clinical Trials.

Guang Chen,Benjun Wei,Jie Wang,Zhaoling Li,Qingyong He,Bo Feng,Zhenpeng Zhang,Robert K Hills

doi:10.1371/journal.pone.0151880

Abstract

ObjectiveTo evaluate the evidence for the effectiveness and safety of Shensongyangxin Capsules (SSYX) for treating paroxysmal atrial fibrillation (PAF).MethodsWe searched for randomized clinical trials for SSYX in PAF up to June 2015. The Cochrane risk of bias tool was used to assess the methodological quality. RevMan 5.3 was used to synthesize the results.ResultsWe included 22 trials involving 2,347 PAF patients. The quality of the included studies was generally poor. The results of the meta-analysis showed that SSYX plus routine treatment was more effective at improving P-wave dispersion (Pwd) and the frequency of PAF attacks compared with routine treatment alone. The results from the included trials that compared SSYX plus routine treatment and arrhythmic drugs plus routine treatment were inconsistent. Trials reported on Pwd, quality of life, frequency of PAF attacks or maintenance rate of sinus rhythm and found that SSYX combined with anti-arrhythmic drugs plus routine treatment was more effective than anti-arrhythmic drugs plus routine treatment. Four of the trials reported adverse events, indicating that SSYX was potentially safer than anti-arrhythmic drugs.ConclusionsThere appears to be some benefit from the use of SSYX. However, due to poor methodological quality, we could not draw confirmative conclusions regarding the beneficial effect of using SSYX.

Highlights

Atrial fibrillation (AF) is the most common arrhythmia and the most serious disorder of atrial electric activity that is associated with the regular displacement of the P-wave by the atrial fibrillary wave
The results of the meta-analysis showed that Shensongyangxin Capsules (SSYX) plus routine treatment was more effective at improving P-wave dispersion (Pwd) and the frequency of Paroxysmal atrial fibrillation (PAF) attacks compared with routine treatment alone
Trials reported on Pwd, quality of life, frequency of PAF attacks or maintenance rate of sinus rhythm and found that SSYX combined with anti-arrhythmic drugs plus routine treatment was more effective than anti-arrhythmic drugs plus routine treatment

Summary

Introduction

Atrial fibrillation (AF) is the most common arrhythmia and the most serious disorder of atrial electric activity that is associated with the regular displacement of the P-wave by the atrial fibrillary wave. There is no evidence to support the idea that controlling the rhythm is better than controlling the heart rate in efforts aimed toward stroke prevention and reducing the death rate. The initial aim of treatment is to reduce the symptoms of the attack. Catheter ablation and drug therapy are important parts of treatment for patients with PAF. Suggested drug therapy includes blood-clot prevention, controlling the ventricular rate, converting AF and maintaining sinus rhythm as well as treating indications, such as protopathy, and complications, such as hypertension, coronary heart disease (CHD), HF and hyperlipidemia. As for PAF, it is important to maintain sinus rhythm, but the curative effects of western medicines on PAF are still unsatisfactory. During long-term treatment with western medicines, typical side effects arise, including the occurrence of other malignant arrhythmias

Results

Discussion

Conclusion