According to a modern understanding of acupuncture mechanisms, acupuncture may elicit vegetative reflexes, presumably influencing the systemwide vegetative dysregulation associated with the heart failure syndrome, a feature of which is low performance in the 6 min walk test. The author performed a preliminary prospective, randomized, single-blinded clinical trial (n=21) in a cross-over design comparing acupuncture treatment, which was either compatible with individual Chinese diagnosis according to the Heidelberg Model of TCM (i-ACU) or a standardized treatment on acupoints with no specific relation to TCM diagnosis (u-ACU). The repeated measures analysis revealed a significant effect for i-ACU vs. u-ACU (F =7.2, df =1.37, P=0.011). The study revealed first evidence that acupuncture may prolong 6 min walk distance as a key parameter of heart failure.