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Comparative effectiveness of acupuncture and antiarrhythmic drugs for the prevention of cardiac arrhythmias: a systematic review and meta-analysis of randomized controlled trials

Abstract

Introduction and objectives. This study was designed to systematically evaluate the effectiveness of acupuncture treatment for arrhythmia compared to existing drug therapy.

Methods. Randomized controlled trials (RCTs) were identified through searches of the MEDLINE, CNKI, Embase, and Cochrane databases (1970 through 2016) and hand searches of cross-references from original articles and reviews. Clinical trials that randomized arrhythmia patients to acupuncture therapy vs. conventional drugs, sham acupuncture, or bed rest were included for analysis.

Results. A total of 13 trials with 797 patients met the criteria for analysis. The results of the meta-analysis showed no statistically significant difference between acupuncture and conventional treatment for paroxysmal supraventricular tachycardia (PSVT) (n = 203; RR, 1.18; 95% CI 0.78–1.79; I = 80%; P = 0.44). However, in the ventricular premature beat (VPB) group, it showed a significant benefit of acupuncture plus oral administration of anti-arrhythmic drug (AAD) on response rates compared with the oral administration of AAD (n = 286; RR, 1.15; 95% CI 1.05–1.27; I = 0%; P = 0.002). Finally, when compared with the sinus tachycardia (ST) cases without any treatment, acupuncture has benefited these patients (n = 120; MD, 18.80, 95% CI 12.68–24.92; I = 81%; P < 0.00001).

Conclusions. In summary, our metaanalysis demonstrates that clinical efficacy of acupuncture is not less than AAD for PSVT. Furthermore, in subgroup analysis, acupuncture with or without AAD, shows a clear benefit in treating VPB and ST. However, more definitive RCTs are warranted to guide clinical practice.

Studienautor: Yanda Li, Barajas-Martinez H, Li B, Yonghong Gao, Zhenpeng Zhang, Hongcai Shang, Yanwei Xing, Hu D (2017)

Quelle: Deutsche Zeitschrift für Akupunktur