Acupuncture and A-fib

I became interested in acupuncture as a treatment for my A-fib after I read this 2012 article: “Acupuncture for paroxysmal and persistent atrial fibrillation: An effective non-pharmacological tool?”

The study tested acupuncture vrs amiodarone therapy given after cardioversion. The authors reported that “In patients with persistent AF, the recurrence rate after acupuncture treatment was similar to that observed in patients on amiodarone”.

“In conclusion, we observed that acupuncture of the Neiguan spot was associated with an antiarrhythmic effect, which was evident in patients with both persistent and paroxysmal AF.”

They cautioned: “These preliminary data, observed in 2 small groups of AF patients, need to be validated in a larger population” But they were enthusiastic. These data: “strongly suggest that acupuncture may be an effective non-invasive and safe antiarrhythmic tool in the management of these patients.”

I couldn’t find evidence that Lombardi, the lead author of the 2012 study, followed up with a larger study. I found various other articles that described encouraging results with acupuncture treatment of A-fib.

I asked my cardiologist about acupuncture. He agreed there are indications in the literature that acupuncture may be a useful treatment, but he pointed out that the encouraging studies did not have large enough numbers of patients enrolled to be convincing.

The Lombardi study speculated as to why acupuncture would work: “The possibility that acupuncture may exert its anti arrhythmic effect through an action on the autonomic nervous system is therefore a plausible hypothesis although not tested in our studies. Indeed, several clinical and experimental reports have indicated that an imbalance of autonomic control mechanisms due to either an increase in vagal or sympathetic neural activity directed to the heart may favour the initiation and maintenance of AF episodes.[1,2] In patients who developed AF during Holter recordings,[38,39,40] signs of either an increased vagal or sympathetic modulation of the sinus node were commonly detected in the minutes preceding AF initiation: a finding that in our opinion, suggests that an imbalance between the two branches of the autonomic nervous system rather than a specific predominance of one component is the most important pro-arrhythmic factor.”

“The possibility that the antiarrhythmic effect of acupuncture might be related to a stabilization of sym-pathetic and vagal control mechanisms rather than to a direct antiadrenergic or vagomimetic effect is therefore appealing and is substantiated by recent experimental findings.”

A large group of cardiologists and acupuncturists in China are about to or are currently doing a large study. They described how they are going to do the study in an article published Jan 2021: “Acupuncture for persistent atrial fibrillation after catheter ablation: study protocol for a pilot randomized controlled trial”

I am trying out acupuncture for the first time. The treatments feel like they are very beneficial for me, although I have no real idea if they will help with my A-fib.

How often do you get episodes. How high is you HR during an episode and how long do they last? Is your Dr an EP? Are you on an anticoagulant ?



Edited 1 time(s). Last edit at 12/01/2021 11:43PM by JoyWin.

Interesting, Neiguan is commonly used to relieve nausea. Wristbands can be used for this purpose

[pubmed.ncbi.nlm.nih.gov]

[pubmed.ncbi.nlm.nih.gov]

[www.mskcc.org]

bands
[www.google.com]

I tried Accupuncture in Australia many years ago while my AF was still paroxysmal. I saw a top accupuncturist (he treated the Aussie Prime Minister). He wasn’t hopeful because, he said, I'd had AF for so many years.

He was right, it didn’t help at all with the AF but I did feel good after each treatment.

Gill (female, pronounced "Jill", nsr since ablations in Bordeaux 2003)

I experienced my first episodes of A-fib more than 3 years ago. There were 4 episodes, all less than 1 week in duration, spread out over several months. I visited the E.D. for all 4 episodes. Cardioversion was attempted on the second episode but my heart did not stay in the sinus rhythm that resulted for longer than a minute. Cardioversion was successful on the 4th episode. The 4th episode was therefore the shortest, lasting less than 1 day.

I saw a cardiologist three times in the period when these episodes were happening. After the first episode, after the second, and after the third. After the third episode, my cardiologist gave me two choices: start taking amiodarone, or he would "bring out the big guns", which I took to mean he would prescribe ablation. In his mind, the only possible thing that would happen to me at that point, unless I did what he told me to do, would be a series of probably steadily increasing bouts of A-fib, that he was at that time diagnosing as paroxysmal, heading toward permanent A-fib. I thought he was a bit arrogant to believe he knew all.

I was under a lifetime high level of stress at the time, due to various events associated with both of my parents suffering from Alzheimer's as they both neared the end of their lives. My sister and my parent's financial advisor had colluded to forge and accept the signature necessary to make my sister the sole owner of my parents entire estate while my parents were living in a locked memory ward sliding into advanced dementia. Just after I discovered this I experienced my first episode of A-fib.

My brief study of why I might be experiencing A-fib indicated that this stress could be a significant contributing factor. I had also read that many patients did not like the side effects of amiodarone, and that these side effects could be substantial. I read that not all doctors of that time thought that ablation was a recommended first line treatment for cases that seemed obviously influenced by sudden high stress levels. I read the FDA sheet on amiodarone, the thing anyone taking it is handed by their pharmacy. What I got out of that was do not initiate taking this drug unless you are in a hospital due to the possibility of sudden death, this drug can make you go blind, etc., etc. (I subsequently have been told that experience with the drug suggests this warning is not actually necessary, but I did not know that at the time). It seemed to me the cardiologist was handing it out like candy. He dismissed my concerns that perhaps this drug was not the right thing for me at that time.

Anyway, I decided that if stress could be the cause of what I was experiencing, and my cardiologist was going to be this adamant about what I had to do, I would reject his advice. I didn't have much of a plan. I thought I would see what I could learn about reducing the effect of stress on my body and hence on my heart. I couldn't get a second opinion appointment with another cardiologist booked for several months in the small town near me, so I was told, and so I thought.

I saw my primary care physician and asked her if she thought I was insane to reject what my cardiologist had prescribed. She recommended that I follow his advice. She said that it seemed to her he was advocating a standard treatment protocol. When I convinced her I was not going to do that, she said stay within range of Emergency Departments. Then she handed me an ad the local Zen center was associated with. They were teaching Mindfulness Meditation, according to the method pioneered by Kabat-Zinn.

I took up meditation a few days later. Within a week I experienced my 4th and last in that series of A-fib episodes. This last episode responded to cardioversion.

I experienced no more episodes for the next more than 3 years. I decided this period of remissions was a cure. Meditation definitely helped me to put the distressing thoughts of what was happening to my parents and to their estate out of my mind for periods of time. Also it gave me valuable insight into how my mind works. I have kept up a daily practice all this time. I feel much more in control of how stressful my experience of life is.

Recently, however, since I assumed I had nothing to worry about in the way of experiencing A-fib again, I was driving myself onward trying to accomplish too much too quickly. I could feel myself getting mentally stressed about some deadline I had set. I was ignoring increased signals that I was becoming physically exhausted. I experienced A-fib for a week starting late this October. I was so set in my belief that I would never experience A-fib again that I could not recognize the symptoms for two days, even though I felt so dizzy after simply getting up out of a chair I fell to the floor. I spontaneously converted to a normal sinus rhythm after one week. It was depressing to experience A-fib again. But I remained confident. This particular stress was something I could easily just let go of. I decided I could forget all about the deadline for completing my project. I stopped working on it altogether and spent days relaxing. I increased my meditation practice and looked forward to the rest of my A-fib free life.

The cardiologist I saw this time listened to this story and thought, well maybe this is what is going to happen, but he started talking to me about ablation as a first line treatment, put me back on blood thinners and prescribed an increased dose of metoprolol.

I've experienced one more episode. This was the longest, at 12 days, I've ever experienced. It resolved spontaneously. The cardiologist now has me seeing the practitioner who is a screen for patients heading to see one of the two EPs here who specialize in ablation. He says ablation is all these guys do. He's trying to get me to take Sotalol. I've agreed to consider ablation, but I've said hold the Sotalol for the time being.

The cardiologist says the ultrasound and stress test he prescribed indicate he needs to do a cardiac catheterization, a.k.a. coronary angiogram, to investigate my heart. He is alarmed at the stress test report. He saw it this afternoon, then he cleared his schedule to see me tomorrow morning. He says he is not certain, but he wants to become certain quickly. He also thinks it is possible that whatever he will discover and attempt to fix will have been something that contributes to A-fib.

I don't feel as lost in the wilderness as I did when I first walked out on my cardiologist three years ago. So I spend a lot of time researching A-fib. I told my cardiologist that I have moved from denying that I have A-fib because I convinced myself I had learned to reduce the effect stress has on my body and heart, therefore curing myself, to accepting that this is what I have.

I don't think my episodes of A-fib are the most symptomatic that I've ever read about, but I would say they are highly symptomatic. I don't feel I have the capability to accurately measure my heart rate during these episodes, but the equipment I have has indicated rates higher than 155 and at times 175. These last two episodes start out somewhat dramatically, then as each day goes by I feel better, until suddenly my heart works normally again.



Edited 3 time(s). Last edit at 12/02/2021 09:42PM by David_L.

Some researchers at Harvard decided a few years ago to see if they could find some basis for why acupuncture works that minds working within the paradigm of Western science could accept. A very recent study found an explanation for one of the effects of acupuncture:

"Harvard Neuroscientists Explore the Science of Acupuncture"

"...these results provide “the first concrete, neuroanatomic explanation for acupoint selectivity and specificity,” Ma added. “They tell us the acupuncture parameters, so where to go, how deep to go, how strong the intensity should be.”

Quote
GeorgeN
"Interesting, Neiguan is commonly used to relieve nausea. Wristbands can be used for this purpose"

These researchers were developing wristbands to treat A-fib:

"Acupuncture on Neiguan spot: A promising therapeutic approach for atrial fibrillation by modulating autonomic nerves?"

Quote
David_L
The cardiologist says the ultrasound and stress test he prescribed indicate he needs to do a cardiac catheterization, a.k.a. coronary angiogram, to investigate my heart. He is alarmed at the stress test report. He saw it this afternoon, then he cleared his schedule to see me tomorrow morning. He says he is not certain, but he wants to become certain quickly.

So you're keeping that appointment, right?

I've tried acupuncture. I've tried wrist bands too.
I don't deny those things can work for some, but they did not for me.

Quote
Carey
So you're keeping that appointment, right?

I'm trying acupuncture with the approval of my cardiologist. He sees no harm that can come from it.

He is most immediately interested in determining why my stress test indicated that several regions of my heart appear to be not receiving enough blood. He will be doing a coronary angiogram in the first opening he has. As well, I am going through whatever process they have here with the EPs that handle all ablations in this county for this institution. I am considering whether I want them to do their procedure. He says these two EPs between them do 5 ablations per day.

I am interested in learning more about who the top flight EPs nearest Washington state are, and whether it would be better, practical or possible to have one of them perform an ablation in a satisfactory timeframe, compared to the EPs available in Bellingham.

My cardiologist is recommending an ablation and I am becoming inclined to agree as I study my situation.

A black cloud magnet take on my experience—I had acupuncture once and arrived at 11:30am. By the time my history was done and the needles placed, it was near lunch time.

The entire office took off for lunch unknown to me until 1:30pm and I was just laying on my stomach in a unlit room with needles head to toe everywhere saying repeatedly “HELLO!! :-)

They returned and apologized. They had forgotten about me.

So I can’t say if it was beneficial or not.



Edited 1 time(s). Last edit at 12/04/2021 09:15PM by susan.d.

Kudos to you for doing what you can to prevent it. It's hard to slow down and relax, but essential. There's a lot more to it though. Read Dr. John D Day's book titled The Afib Cure. Read Dr. Dennis Goodman's book Magnificent Magnesium. A lot of people on this forum use a pill in the pocket of a high dose of fleccanaide ONE TIME at the beginning of an Afib episode to make it stop. I have been to 9 different cardiologists/EPs in 3 different states and NOT one of them offered this to me. Sotalol made my Afib MORE frequent. I finally asked my EP if I could try the high dose fleccanaide (150 mg for me at 125 lbs) and he said "sure". Only had to use it once and AF stopped in 3 hours. Don't let yourself stay in AF for very long. The longer you are in ti, the more the Heart begins to remodel and tends toward it. Breathe, deep breaths, keep blood sugar level (no spikes) Exercise every day, but not too much...... Get your RBC Mg tested (PM me if you don't know what this is) Stress burns through your Mg stores in the cells, leaving your poor muscles deficient and your heart needs it the most. Everyone here says Dr. Natale in Austin TX is the best in the land for an ablation. I had to have someone else do mine because covid had him closed and I couldn't wait or even travel back then. But make sure who ever does it has a good track record and is proud to tell you success rate. Ablation done by the right doctor is the best thing since sliced bread! BUT even afterward, you must be proactive and avoid the triggers. Best wishes to you!

I finally asked my EP if I could try the high dose fleccanaide (150 mg for me at 125 lbs) and he said "sure"

OMG. I too asked an EP at 121 pounds and he said yes and said it was safe and to prove it I was to take after five days a stress test. During the test I went into V-tach and an ambulance took me downstairs where I spent three days in the ICU with 24 hr. The Ep looked at me and said v-tach from too much flecainide was what he was testing for. Before the test he said in ten minutes he will see if I could handle the increased dosage at my weight. I was diagnosed with flecainide overdose. Just because a doctor says “sure” doesn’t mean he is competent to safety advice you. That’s why they carry malpractice insurance for these guys.

Get a second opinion. I was told by the icu charge nurse I almost died. You don’t want to experiment with flecainide. Trust me.

I agree with SusanD about flecainide (and it's worth for propafenone too). There's a max dose related to the patient's weight... but it's theoretical. I can't, for myself, tolerate the lower dose (confirmed with stress test). Be careful. Some can be fine with flec, others not, at any dose.