| Objective:This study aimed to investigate the effect of acupuncture on the early recurrence rate of Atrial fibrillation,heart rate variability and quality of life after radiofrequency ablation in patients with Atrial fibrillation.Methods:Seventy patients with Atrial fibrillation after radiofrequency ablation who attended the Department of Cardiology,Tianjin Chest Hospital between August 2020 and December 2021 were included in the study,and they were randomly assigned to the acupuncture group and sham acupuncture group according to a 1:1 ratio.These patients received acupuncture within1 week after radiofrequency ablation,2 acupuncture sessions per week for the first 6 weeks of treatment and 1 acupuncture session per week for the second 6 weeks,and the efficacy of acupuncture was evaluated at the end of treatment.The primary outcome indicator was the rate of early recurrence of Atrial fibrillation.Secondary outcome indicators including: heart rate variability,quality of life assessment of atrial fibrillation,percentage of time to premature atrial flare episodes and adverse events from needling.All data were analysed by using SPSS21.0 software and plotted by using Graph Pad Prism 8.0 software.Results:Main outcome indicators:The recurrence rate of Atrial fibrillation was 11.76% in the acupuncture group and17.65% in the sham acupuncture group,with no statistical difference between the two groups(difference 0.85,95% CI 0.75 to 0.93,P=0.734).Secondary outcome indicators:1 Heart rate variability(1)The mean heart rate of the population in the post-treatment acupuncture group was(47.00±6.90)beats/min and the mean heart rate in the sham-acupuncture group was(49.92±6.45)beats/min.There was no statistical difference in the mean heart rate between the two groups(difference-2.91,95% CI-6.15 to 0.32,P=0.077).(2)After treatment,the LFNu of patients in the acupuncture group was(47.86±17.38)nu and the LFnu of patients in the sham group was(37.84±15.68)nu.There was a statistical difference in LFNu between the two groups(difference 10.02,95% CI 2.00-18.03,P=0.015).The HFNu of patients in the acupuncture group was(51.91±17.36)nu and the HFNu of patients in the sham-needle group was(61.95±16.65)nu,and there was a statistical difference between the HFnu of patients in the two groups(difference-10.03,95% CI-18.03 to-2.03,P=0.015).(3)The median LF/HF of patients in the acupuncture group was 0.78(1.38)and the median LF/HF of patients in the sham group was 0.76(0.66),with a statistical difference between the two groups(difference 0.27,95% CI 0.01 to 0.53,P=0.039).2 Evaluation of quality of life in patients with atrial fibrillation(1)After treatment,both the acupuncture group and the control group showed a statistically significant increase in the total score on the quality of life scale compared with that before treatment(P<0.05).However,after treatment,there was no statistically significant comparison between the two groups(difference 0.03,95% CI-0.02 to 0.07,P=0.310).(2)After treatment,the median pain score was-0.037(0.037)in the pain dimension acupuncture group and-0.04(0.009)in the sham acupuncture group,with a statistically significant difference between the two groups(difference 0,95% CI 0 to 0.02,P=0.037).(3)After treatment,patients in the acupuncture group and the control group showed significant and statistically significant improvements in all four dimensions of physical fitness,social functioning,mental health and energy compared with those before treatment(P<0.05),but there was no statistically significant difference between groups in four dimensions(P>0.05).(4)There was no significant improvement in the limitation of daily activities dimension in either group before or after treatment,and it was not statistically significant(P >0.05).3 Percentage of time to premature atrial onsetAfter treatment,the median percentage of time to premature atrial episodes was 0.08(0.14)% in the acupuncture group and 0.16(0.31)% in the sham-needle group,with no statistically significant difference in the percentage of time to premature atrial episodes between the two groups(difference-0.02,95% CI-0.11 to 0.03,P=0.216).4 Acupuncture adverse events: there were no acupuncture-related adverse events in either the acupuncture or control groups.Conclusions:1 The efficacy of the acupuncture group in reducing the early recurrence rate after radiofrequency ablation was similar to that of the sham acupuncture group.2 Acupuncture improved sympathetic and parasympathetic balance and reduced vagal tone in patients with Atrial fibrillation after radiofrequency ablation.3 Acupuncture improved the quality of life of patients with Atrial fibrillation after radiofrequency ablation.Compared with the sham-needle group,the acupuncture group was more effective in reducing the pain symptoms of patients after radiofrequency ablation.4 There was no significant difference between the acupuncture group and the sham-acupuncture group in the percentage of time to atrial premature episodes within three months. |
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