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We are not quite sure from your question whether you mean atrial flutter or atrial fibrillation. The difference between them is not substantial - in fibrillation the increased atrial beat is irregular whereas in flutter the increase tends to be regular - but the impact of both is much the same: faintness, tiredness, palpitations, shortness of breath and dizziness.

We have answered questions on atrial fibrillation before, a typical answer being:

There are some early indications that acupuncture may have an anti-arrhythmic effect in patients with atrial fibrillation. A study published earlier this year

concluded that there appeared to be benefits and that further large scale trials would be valuable to test the hypothesis more carefully.

However, it is only fair to say that needling a single point such as Neiguan repeatedly is not a fair representation of what a traditional acupuncturist does in practice. Although there is considerable overlap between eastern and western systems the arrhythmia typical of AF could be classified in several different ways within Chinese medicine, and the practitioner would be guided by evidence other than simply a reading of the rate of the pulse. That in turn would mean that ten people with AF might receive ten different treatments. To that extent, it is not that straightforward to extrapolate from research studies like this and conclude that 'acupuncture works'. 

The skill of the practitioner lies in making sense of the symptom of AF within an entirely different theoretical framework, and understanding each presentation in each individual patient as unique. The best advice we can give any prosepctive patient is to contact a BAcC member local to them to seek a short face to face consultation at which they can be given a better assessment of whether acupuncture might benefit them.

The one caution with AF is that most patients are taking some form of medication to control the problem, and the cessation of medication can quickly provoke a return of the symptoms. For people involved in highly technical or responsible work this might represent a serious risk. We would always recommend that any member contemplating treating someone with a condition like AF should talk to the patient's GP to ensure that nothing they do will undermine the current treatment regime. 

We have undertaken some further searches of the literature and these two articles

say much the same as the earlier articles and indeed cite them frequently.

Most of us have treated AF cases, and they do represent something of a challenge because of the management of the case alongside western treatment and medication. Even where we manage to bring the episodes under control to a greater degree than the medication most medical practitioners are reluctant to stop the meds in case the patient has a serious recurrence when they are doing something which could have dangerous consequences (driving a car, etc etc). However, good dialogue can address these kinds of problems, and a patient with their symptoms under control is likely to be happy to facilitate good communication anyway.

The other slight issue is with the setting of outcome measures. AF can come and go, and a problem-free period can happen anyway, so a practitioner has to be careful to discuss with the patient what would count as evidence from the patient's perspective that there had been some progress.

This represents probably the best that we can still say. There is no evidence of research into atrial flutter as such, and we suspect that for the purposes of the trials which have taken place the distinction has not been drawn.

What we did not say in our earlier reply is that most of our members are only too happy to give up a little time to prospective patients, usually without charge, to give them a better idea of what may be possible. Most conditions like this do not occur in isolation from a Chinese medicine perspective, and there are often other signs and symptoms which together make more sense of what is happening. From a Chinese medicine perspective each person is unique and different, and although a dozen patients share the same named condition there may be a dozen different ways of looking at it and treating it. Having a  word with a skilled and experienced practitioner might make more sense of what is going on and give a better idea of how treatable it may be.

We suppose the underlying issue here is whether the mitral valve prolapse is actually connected to the symptoms which your son is experiencing. The ones which you report are not the standard problems noted in these cases, and if this is a separate and unrelated problem then it substantially changes the advice we can offer.

As far as the treatment of MVP itself is concerned there is no evidence that we can find that acupuncture treatment has been documented in helping to reduce the symptoms associated with MVP. There are several complementary medicine articles which point to the use of magnesium, which has been linked to the muscle weakness, but nothing which mentions treatment by acupuncture. Whether magnesium is effective as a supplement is beyond our scope for comment.

If, however, the symptoms are of a different problem related to a weakened immune system, i.e. not directly resulting from the MVP, then there may be some reason for cautious optimism. There have been a number of studies which have shown effective increases in immune response and immune system body chemistry as a consequence of treatment, and a greater number of studies of of successful treatment of some of the emotional disorders associated with a weakened immune response, anxiety being one of the primary ones. The research is far from conclusive, but suggestive of the fact that there may be a chance that change will happen.

The bottom line with complex presentations is that it really needs someone to take a look at the individual to see how the symptoms present against the backdrop of all aspects of the person's health. Not only does the traditional acupuncturist treat the individual rather than simply treat the condition, but the health of the individual can seriously affect the speed with which something can clear up, or indeed whether it can clear up. The best advice is to see a local practitioner for this kind of informal assessment before committing to treatment.

The one caution about treating anyone with MVP is that there is thought to be a known increase in risk of endocarditis if the skin is not cleaned before needles of any kind are inserted, and there is an absolute embargo on the use of any form of retained needle. This is occasionally disputed, as in this paper

but we always advise our members to treat people with heart valve problems as though they were immuno-compromised

Q: Hi. I suffer from ventricular ectopics,I have seen Drs regularly and take beta blockers which work to a degree. I have periods when things aren't too bad and periods when things are really bad,I do get quite down during these times. Do you think acupuncture would help?

A: We have been asked similar questions before, and in reply to one we said:

One has to be very careful answering questions such as these. Taking the pulse a the wrist is one of the key diagnostic techniques in Chinese medicine, along with looking at the tongue and a number of other evaluations. The irregular pulse has clinical significance in the tradition, and point to specific disorders of organic function as understood within this paradigm of medicine. However, these may not all involve the heart - in fact, most of them don't - and any suggestion that this is treating the heart as it is understood in the west needs to be set aside.

From a conventional medicine point of view, there is not a great deal of evidence that acupuncture can treat these problems, although what little there is does tend to be very positive, although not always methodologically sound enough to use as the basis for a recommendation. A good example of a systematic review is:

Some of the published research also involves animal experiments, sometimes called 'ratpuncture' in the trade, and although the results here may be promising it is quite a large assumption to believe that human physiology will respond in the same way.

We think that it would certainly be worthwhile talking to a BAcC member local to you about what the conditions may be telling them about the way your system as a whole is functioning. From our perspective all of our members are equally well-qualified to deal with the vast majority of patients who present at their clinics, and it is obvious from what we have said earlier that there are no specialists in heart problems per se - Chinese medicine primarily treats the person, not the condition which someone has.

There have been a couple of other systematic reviews

which make largely positive noises, but as in all of these kinds of studies the treatment which is given is largely formulaic, and does not really represent what a traditional acupuncturist does, which is to gear treatment to the individual and his/her unique balance of energies. Where trials offer designs which allow the practitioner to do what they might normally do, so called 'black box' trials, the results tend to get better and better.

The bottom line, though, is that from a Chinese medicine perspective there are often functional disturbances which can generate symptoms, often far away from the source of the manifesting problem. The skill and art of the practitioner is to make sense of the diagnostic information and treat the root of the problem. This can often cause a symptom to reduce or even disappear without there having been any apparent connection between where the needles were placed and the part of the body in distress.

The advice we gave before still holds good, to visit a local BAcC member for advice and a short face to face assessment of what may be happening. Most BAcC members are only too happy to give a small amount of time without charge to prospective patients to enable them to assess whether acupuncture is the best treatment for their problem. This will obviously give a far better idea of what may be possible than what we can say at a distance.

Q: My son has terrible hay fever and I want to know if acupuncture is any good in illeviating this and who would be the best person to go to near to Newcastle under Lyme to treat the condition

A: There isn't a great deal of research under the heading of 'acupuncture and hay fever' on which we can draw for evidence of the success of acupuncture treatment, and what we do have on our website is a factsheet for allergic rhinitis with which there i very considerable overlap.

We have checked the databases, though, and while you will find occasional studies like this one

there are not as many as you might expect. We suspect that this is because the random timing of the occurrence of the problem makes it difficult to assemble a cohort of sufferers to run the trial.

The one thing we can say with certainty, though, is that it often helps to start treating two or three months before someone would normally start their symptoms in order to achieve the best results. Once the problem has started and bedded in it can be a great deal harder to address. Treating the person rather than the symptom is central to Chinese medicine, so working in advance of seasonal symptoms is quite a normal pattern of work anyway and one which would probably strengthen the immune system. We often find that sufferers still get small traces of symptoms but nothing like the effects they have had in the past.

You haven't mentioned whether your son is a child or not. If he is, then this bodes well for treatment. Children are not simply small adults, and many members undertake postgraduate training in paediatric acupuncture to work with children. We cannot make recommendations but we ran a quick google search using key words like your home town, acupuncture and children, and quickly generated some interesting results.

Hay fever comes in all shapes and sizes, though, and it would be best for you to see if someone is prepared to take a look at your son and see what they think. Most of our colleagues are more than happy to give up a little time without charge to talk to prospective patients, and we find this works to everyone's advantage.

In our experience younger children respond very well to treatment, often requiring minimal intervention to get really significant results. If your son doesn't fancy needles, though, we cna say that Chinese Herbal medicine and classical homeopathy both see, in our view, to offer some interesting alternatives. Both have received quite bad press over the last few years, but we have seen many patients whose experience of both modalities has been very good.

Q: I've read that acupuncture raises blood pressure in individuals with normal blood pressure. Does this always happen and if so, after treatment, does the blood pressure go back to normal?

A: We have looked carefully through all of the research databases and checked for anecdotal accounts on the web, but apart from people who have experienced a raised blood pressure as a nervous response to having treatment itself, there is no evidence to suggest that acupuncture would raise blood pressure in someone with a normal blood pressure. Clearly if someone has low blood pressure, treatment might have the effect of normalising it, but the primary effect of acupuncture on blood pressure is to lower it. This is a well attested outcome, and we have have seen thousands of patients over the years who have hypertension as a primary or secondary problem, many of whom have seen considerable improvements after treatment.

That is not to say that it cannot happen, and if you have come across some research which we have missed we would be very grateful for the reference. Things do change, and surprising results do emerge, but something as important as this would generally bubble to the surface quite quickly.

Our own fact sheet on hypertension is not as informative as some others we produce, and the evidence is not to the standard where we would be making specific claims for the benefits to be derived from treatment. Most of the studies, however, fail on methodological grounds, but all report a lowering of blood pressure with treatment.

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