Acupuncture versus pharmacological conversation in treatment of atrial fibrillation in a randomized controlled trial: a systemic review and meta-analysis

OBJECTIVE: This study aimed to investigate the effect of conventional drugs combined with acupuncture therapy on the conversion of sinus rhythm in patients with atrial fibrillation. METHODS: We searched databases, such as PubMed, Embase, WOS, Cochrane, CNKI (China National Knowledge Infrastructure), Wan fang Data, VIP, and CBM to collect data in randomized controlled trials of acupuncture included patients with atrial fibrillation. Publication time was limited from the beginning to May 15, 2021. The primary outcome is the number of participants who converted successfully. RESULTS: A total of 11 papers were included in this study. The combined effect indicated that acupuncture significantly effectively benefitted the patients with atrial fibrillation (RR = 1.208, 95% CI 1.123, 1.298, P < 0.001). Further subgroup analysis of persistent and paroxysmal atrial fibrillation and the timing of acupuncture suggested that the addition of acupuncture was not statistically significant in the treatment of persistent AF compared to the control group (RR = 1.147, 95% CI 0.811, 1.623 P = 0.147). The combination of acupuncture was more effective in paroxysmal AF RR = 1.148 (95% CI 1.064, 1.239) P < 0.001. In addition, when the acupuncture time was limited to 20 min, it had the best treatment effect (RR = 1.510, 95% CI 1.25, 1.82). CONCLUSIONS: The combination of pharmacological resuscitation with acupuncture significantly improved the conversion of paroxysmal atrial fibrillation compared to pharmacological resuscitation only. The most significant benefit was achieved with an acupuncture duration of < 20 min. Thus, the combination of acupuncture could be considered in clinical practice for the resuscitation of patients with atrial fibrillation.