Ask an expert - body - chest

47 questions

Q I suffer from atrial fibrillation and have heard that acupuncture can help restore the heart to its normal sinus rythm. Is this the case? If so how would I find an acupuncturist who specialised in this field?

 

A: There are some early indications that acupuncture may have an anti-arrhythmic effect in patients with atrial fibrillation. A study published earlier this year
 
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312232/
 
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 esnure that nothing they do will undermine the current treatment regime. 
 
 

The majority of cases of venous insufficiency involve the circulation in the lower limbs, and while there is very little specific western research on this, we have to remind people that Chinese medicine has dealt with problems liek this for centuries, and has a number of treatment strategies for problems in which this is one of the symptoms.

 

 

It is important to be aware that Chinese medicine operates from an entirely different conceptual basis in which the flow of energy, called 'qi' in Chinese, is central to the effective flow of all body fluids and to the overall balance of the system. The practitioner of Chinese medicine uses his or her skills to try to determine how the system is out of balance and then devises treatment strategies to correct imbalances. In some cases this is symptom led, and in other cases, the treatment is much more general, aimed at correcting the overall balance premised on the simple belief that when a system is in balance, symptoms repair themselves.

 

The best course of action is to visit a BAcC member local to you to seek their advice on whether your particular case makes sense from a Chinese medicine perspective and what they would advise. In many cases acupuncture would be an appropriate treatment, but there may be other options which a practitioner may recommend as better suited for what specifically troubles you.

Although there are one or two studies published in China (and in Chinese!) which have shown promising results, there is no hard evidence that acupuncture has been proven to have a strengthening effect on the heart. For conditions such as this acupuncture may well have a general supporting function, insofar as the basic premise of Chinese medicine is to treat the person, not the disease, but it would be alongside conventional treatment, complementary and not alternative.

 

 

What we can say with a good degree of certainty is that as long as someone continues with their conventional treatment there is very little likelihood of acupuncture causing any harm. The safety statistics for acupuncture in the UK are exemplary, and even across the globe and taking in all forms of sub-optimal practice the incidence of serious adverse events is very low.

 

Both acupuncture and Chinese herbal medicine work from an entirely different knowledge base which looks at the overall functioning of the system rather than simply repairing the bits that go wrong. The symptoms which form the basis of a diagnosis in the West are used in Chinese medicine to underpin a diagnosis in entirely different terms, and the practitioner will aim to correct the imbalances and blockages which manifest as these symptoms. In that general sense there is a possibility of making everything function better.

 

This is not quite the same as claiming to help specific organs, and practitioners are cautioned at the beginning of their training to remember that an organ understood in Chinese medicine terms is not the same as the physical organ described in the West. It often embraces it, but includes a wide variety of other functions, not always physical. This is why Chinese medicine textbooks use the capital letter (Heart) to differentiate from the physical organ (heart).

 

We are not aware of any reason why acupuncture is contra-indicated when someone has had a stent or stents inserted. The only advice we give to members in this area is to avoid using retained needles when someone has had a heart valve replaced and to avoid electroacupuncture if someone has a pacemaker. The second is self-explanatory and the first is because there is a slightly increased risk of endocarditis in people who have had rheumatic heart disease and artificial valves implanted if needles are left in place for a long time.

 

 

Acupuncture when performed by a fully qualified and properly trained professional remains an extremely safe procedure.

We're not entirely sure what you mean by 'modern acupuncture'? This can either mean western medical acupuncture of a kind used most often by doctors, or it can mean traditional acupuncture used in a way which is aimed at a specific condition rather than using it in a traditional way which sees named conditions as the manifestation of a deeper pattern of disharmony.

 

 

The research which has been done has used both types. We have summarised the information in a Review Paper to be found here but this is a fairly dense piece of information in comparison with our fact sheets which are a little easier to access. The summary of findings is encouraging but not conclusive. This is not a surprise to us, though; the format for running trials of acupuncture for asthma are not particularly sensitive to the way acupuncture is practised in everyday use. There is a long history of treating asthma-related conditions in Chinese medicine, and we hope that in time this is validated by research which meets the current western models of best practice.

The one factor which it is very important to bear in mind is that doctors are reluctant to encourage people to come off the long term medications which they are taking for asthma, especially steroids. We encourage our members to be careful only to talk in terms of reducing the medications over which patients can exercise some choice, the 'puffers' like salbutamol/ventolin.

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