Lin Jingming (Tiedong Hospital, Anshan Iron and Steel Company)
For arrhythmias, all the related ECG changes are already known. As for its treatment, in recent years, acupuncture therapy has received a certain degree of attention. A number of reports on its application in atrial fibrillation, angina pectoris etc. have appeared in the medical literature in our country and abroad. But articles related to clinical identification of needle effect and its mechanism are not often seen. In the past few years, we improved on the former method of observing various therapeutic effects after needling a few selected points by observing the changes of a few selected ECG abnormalities on needling a large number of "effective" points. Here, part of the results obtained is presented as below: (1) Needle effect on ventricular premature beats: Acupuncture does diminish or abolish ventricular premature beats, such as bigeminy, trigeminy etc. In organic heart diseases, its effective rate is 72.6% in 112 cases observed. But in nonorganic patients the rate is only 12.5% in a group of 16 cases. The points commonly used include Zusanli, Sanyinjiao, Tiaokou, Chengshan etc. Acupuncture effect can be prolonged by using electric needle or point injection. This method is also suitable for the treatment of the cases with digitalis intoxication. (2) Needle effect upon atrial premature beats: Acupuncture shows diminishing or abolishing effects on atrial premature beats, bigeminy, trigeminy etc. and helps to control various atrial arrhythmias. In a group of 48 cases, the effective rate is 73.8%. One may try left or right Hegu point and sometimes add Quchi or Zusanli with good results. (3) Needle effect on paroxysmal atrial tachycardia: Acupuncture does diminish its ventricular rate and even convert it directly into sinus rhythm. In a group of 12 cases, the effective rate is 66.7% and 41.8% in 55 observations. The points, such as Zusanli, Sanyinjiao, Burong, "Baliao" etc. are usually effective. The efficacy seems equal to that of carotid sinus compression. In skilled hands this method may be more convenient than drug therapy and other methods. (4) Needle effect upon atrial fibrillation: Acupuncture manifests cardioversion in some of the early or paroxysmal atrial fibrillation cases. In 48 observations of 32 patients, the effective rate is 60.4%. Although this method is more safe and simple to apply than drug or d.c. countershock therapy, it requires more skill and not so easy to master at the beginning. Some points such as Xinsu, Quchi, Dazhui, Sufu, Tanzhong, Sanyinjiao etc. have been tried with good results, but not one is found specific. Conversion does appear sometimes with only one point needling, but in some cases it may not be converted until 28 or more point-needlings are performed. While in chronic atrial fibrillation the conversion rate is only 1.1% in a group of 89 observations in 39 patients. The reason is to be ascertained.
Since the principles and mechanisms of needle therapy in arrhythmias remain unknown, its routine application requires a more profound theoretical and technical training. Sometimes, its effects do not last long enough and may vary unexpectedly. All these are to be improved in the future.
At present we suggest that the regulating effect of acupuncture therapy in arrhythmias may be regarded as manifestations of certain somato-visceral reflexes, which are induced by point stimulation and transmitted by way of autonomic nervous system to the heart. Needle effects may be influenced by such factors as patients's conditions, experiences of the doctors etc. It appears that needling may exert its effect through exogenic negative feedback mechanism and it is in agreement with principles of cybernetics. Acupuncture cardioversion together with acupuncture anesthesia are all new advances of traditional acupuncture and moxibustion therapy. It deserves further study and explanation.
For arrhythmias, all the related ECG changes are already known. As for its treatment, in recent years, acupuncture therapy has received a certain degree of attention. A number of reports on its application in atrial fibrillation, angina pectoris etc. have appeared in the medical literature in our country and abroad. But articles related to clinical identification of needle effect and its mechanism are not often seen. In the past few years, we improved on the former method of observing various therapeutic effects after needling a few selected points by observing the changes of a few selected ECG abnormalities on needling a large number of "effective" points. Here, part of the results obtained is presented as below: (1) Needle effect on ventricular premature beats: Acupuncture does diminish or abolish ventricular premature beats, such as bigeminy, trigeminy etc. In organic heart diseases, its effective rate is 72.6% in 112 cases observed. But in nonorganic patients the rate is only 12.5% in a group of 16 cases. The points commonly used include Zusanli, Sanyinjiao, Tiaokou, Chengshan etc. Acupuncture effect can be prolonged by using electric needle or point injection. This method is also suitable for the treatment of the cases with digitalis intoxication. (2) Needle effect upon atrial premature beats: Acupuncture shows diminishing or abolishing effects on atrial premature beats, bigeminy, trigeminy etc. and helps to control various atrial arrhythmias. In a group of 48 cases, the effective rate is 73.8%. One may try left or right Hegu point and sometimes add Quchi or Zusanli with good results. (3) Needle effect on paroxysmal atrial tachycardia: Acupuncture does diminish its ventricular rate and even convert it directly into sinus rhythm. In a group of 12 cases, the effective rate is 66.7% and 41.8% in 55 observations. The points, such as Zusanli, Sanyinjiao, Burong, "Baliao" etc. are usually effective. The efficacy seems equal to that of carotid sinus compression. In skilled hands this method may be more convenient than drug therapy and other methods. (4) Needle effect upon atrial fibrillation: Acupuncture manifests cardioversion in some of the early or paroxysmal atrial fibrillation cases. In 48 observations of 32 patients, the effective rate is 60.4%. Although this method is more safe and simple to apply than drug or d.c. countershock therapy, it requires more skill and not so easy to master at the beginning. Some points such as Xinsu, Quchi, Dazhui, Sufu, Tanzhong, Sanyinjiao etc. have been tried with good results, but not one is found specific. Conversion does appear sometimes with only one point needling, but in some cases it may not be converted until 28 or more point-needlings are performed. While in chronic atrial fibrillation the conversion rate is only 1.1% in a group of 89 observations in 39 patients. The reason is to be ascertained.
Since the principles and mechanisms of needle therapy in arrhythmias remain unknown, its routine application requires a more profound theoretical and technical training. Sometimes, its effects do not last long enough and may vary unexpectedly. All these are to be improved in the future.
At present we suggest that the regulating effect of acupuncture therapy in arrhythmias may be regarded as manifestations of certain somato-visceral reflexes, which are induced by point stimulation and transmitted by way of autonomic nervous system to the heart. Needle effects may be influenced by such factors as patients's conditions, experiences of the doctors etc. It appears that needling may exert its effect through exogenic negative feedback mechanism and it is in agreement with principles of cybernetics. Acupuncture cardioversion together with acupuncture anesthesia are all new advances of traditional acupuncture and moxibustion therapy. It deserves further study and explanation.
1 comment:
Dear Lin,
Thank you very much for posting this interesting information about possible acupuncture therapy for arrhythmias. I am the managing editor of a monthly medical journal called EP Lab Digest; we would love to have you submit an article about this potential therapy. Please contact me at "jelrod@hmpcommunications.com" at your soonest convenience. For more information about our journal, please visit "www.eplabdigest.com".
Thank you!
Best regards,
Jodie Elrod
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