Jade Health Acupuncture · Clinical Blog
Acupuncture for Arrhythmias: Mechanisms, Clinical Insights, and Future Directions
Exploring how acupuncture, TEAS, and vagus nerve stimulation may support heart rhythm regulation as a complementary therapy.
Heart rhythm disorders—known as arrhythmias—occur when the heart beats too fast, too slow, or irregularly. Symptoms may include palpitations, chest tightness, dizziness, fatigue, or a sense that the heartbeat is “unstable.” While cardiology treatments remain essential, acupuncture and related neuromodulation techniques have gained increasing attention as complementary approaches that may help regulate heart rhythm and relieve palpitations.
This article summarizes current research findings, modern mechanisms, clinical applications, and future research directions from the perspective of an integrative acupuncture practice.
1. Introduction
Modern cardiology recognizes that arrhythmias are strongly influenced by:
- autonomic nervous system imbalance (sympathetic and parasympathetic)
- inflammation and oxidative stress
- cardiac electrophysiology and structural remodeling
- psychological stress, sleep, and emotional state
Acupuncture interacts with many of these same systems, offering potential benefits as an adjunct treatment, particularly at the level of autonomic regulation and symptom relief.
2. Transcutaneous Electrical Acupoint Stimulation (TEAS)
Clinical studies led by Li Ying et al. found that transcutaneous electrical acupoint stimulation (TEAS):
- significantly reduces palpitation symptom scores,
- improves traditional Chinese medicine (TCM) symptom patterns related to “palpitations”,
- and helps stabilize certain types of arrhythmias.
These findings support TEAS as a non-invasive neuromodulation method with measurable clinical value in selected arrhythmia patients.
3. Vagus Nerve Stimulation and Atrial Fibrillation
Research by Stavrakis and colleagues demonstrates that transcutaneous vagus nerve stimulation:
- reduces inflammatory cytokines,
- decreases atrial fibrillation duration and inducibility,
- and improves clinical symptoms in patients with paroxysmal AF and cardiovascular disease.
These results highlight the vagus nerve as a key target for heart rhythm regulation and provide a modern physiological explanation for acupuncture's effects on palpitations and arrhythmias.
4. Mechanisms of Acupuncture in Arrhythmia Regulation
Acupuncture influences multiple physiological systems through a layered network of neural, endocrine, and electrophysiological mechanisms.
4.1 Neural Pathways
Stimulation of acupoints activates somatic sensory pathways, sending signals to the thalamus, brainstem, and the rostral ventrolateral medulla (RVLM). These centers regulate autonomic output, helping to stabilize heart rate and rhythm patterns.
4.2 Neurotransmitter Modulation
Acupuncture modulates the release of various neurotransmitters, such as endorphins and serotonin (5-HT), along with other neuromodulators that participate in cardiovascular regulation. This contributes to both symptom relief and autonomic balancing.
4.3 Autonomic Nervous System Balance
By enhancing vagal activity and reducing excessive sympathetic tone, acupuncture can:
- improve heart rate variability (HRV),
- reduce stress-related tachycardia,
- and support more stable rhythm behavior over time.
4.4 Anti-inflammatory and Hormonal Effects
Studies suggest that acupuncture can lower inflammatory responses, activate the pituitary–adrenal axis, and improve coronary circulation. These effects may reduce arrhythmia triggers and improve overall cardiac resilience.
4.5 A Synergistic Multi-factor Mechanism
Rather than working through a single pathway, acupuncture acts via an integrated network of neural, endocrine, and cardiac mechanisms. This multi-target, whole-system nature aligns with both traditional Chinese medicine theory and modern systems physiology.
5. Discussion and Future Research Directions
Current research shows promising trends, but several limitations remain:
- small sample sizes in many trials,
- heterogeneity in acupoint selection, stimulation parameters, and treatment duration,
- lack of standardized treatment protocols,
- limited long-term follow-up data,
- and individual variability in response to vagus nerve modulation.
Future research may focus on:
- standardized treatment protocols (acupoints, frequency, stimulation parameters),
- stratified studies for specific arrhythmia subtypes,
- multi-center randomized controlled trials (RCTs) in collaboration with cardiology,
- objective quantification using autonomic indicators such as HRV,
- and exploration of synergistic mechanisms between acupuncture and anti-arrhythmic medications.
6. Conclusion
Acupuncture, TEAS, and vagus nerve stimulation have shown potential in regulating cardiac rhythm, stabilizing autonomic function, reducing palpitations, and supporting cardiovascular health.
Their mechanisms involve integrated neural, endocrine, and electrophysiological pathways, offering multi-target and system-level advantages.
Although more high-quality research is needed, current evidence supports positioning acupuncture as an important complementary therapy and neuromodulation tool in the management of arrhythmias and palpitations. With further cardiology collaboration, multi-center RCTs, HRV-based objective analysis, and careful clinical documentation, acupuncture may play an increasingly meaningful role alongside conventional cardiovascular care.
Jade Health Acupuncture · 臨床部落格
針灸治療心律失常：作用機制、臨床洞見與未來方向
從現代研究與中醫視角，整理針灸、經皮穴位電刺激與迷走神經刺激在心律失常與心悸中的可能角色。
心律不整是指心臟跳動過快、過慢或不規則。常見症狀包括心悸、胸悶、暈眩、疲倦，或覺得心跳「忽快忽慢、不太穩定」。近年越來越多研究指出，針灸與神經調節技術（如經皮穴位電刺激 TEAS、經皮迷走神經刺激 tVNS）在改善心悸、自律神經失衡與心律穩定方面，具有一定輔助潛力。
本文以臨床交流為目的，整理目前研究進展、作用機制、臨床應用與未來研究方向。
一、前言
現代醫學認為，心律不整的發生與下列因素密切相關：
- 自律神經失衡（交感／副交感）、
- 發炎與氧化壓力、
- 心臟電生理與結構重塑、
- 壓力、睡眠與情緒等身心狀態。
針灸恰好可以從神經系統、自律神經、體液調節與整體身心狀態等多層面介入，因此被視為心律失常與心悸管理中一項具有潛力的輔助療法。
二、經皮穴位電刺激（TEAS）
李穎等人透過臨床研究發現，經皮穴位電刺激可以：
- 明顯減輕患者心悸症狀、
- 降低中醫心悸症狀積分、
- 並在部分心律失常指標上呈現改善趨勢。
這些結果顯示，TEAS 作為一種安全、非侵入式的神經調節方式，在特定類型的心律失常患者中具有可觀察的臨床價值。
三、迷走神經刺激與心房顫動
Stavrakis 及其團隊的研究顯示，經皮迷走神經刺激可以：
- 抑制發炎因子、
- 降低心房顫動的持續時間與誘發性、
- 改善陣發性房顫與部分心血管疾病患者的臨床症狀。
該研究凸顯迷走神經在心律調節中的核心地位，也為針灸「安神寧心」「調節心率」的臨床觀察提供了現代生理學的解釋。
四、針灸調節心律的現代作用機制
從現代醫學的角度來看，針灸對心律失常的調節作用可以大致歸納為以下幾個層面：
4.1 神經傳導路徑
針刺不同穴位時，刺激首先經由體感神經傳入中樞，依序激活丘腦、腦幹以及延髓腹外側區（RVLM）等神經元區域，進而調節交感與副交感神經輸出，對心率與心律產生調控作用。
4.2 神經遞質調節
研究顯示，針灸可影響多種神經遞質的釋放，包括內啡肽、5-羥色胺（5-HT）及其他參與心血管調節的物質，從而在某種程度上改善心悸、焦慮與緊張等症狀。
4.3 自律神經平衡
針灸透過強化迷走神經活性、抑制過度交感亢進，可：
- 提升心率變異度（HRV）、
- 減少壓力相關心跳過快、
- 使心跳節律更趨平穩。
4.4 抗發炎與體液調節
部分研究指出，針灸可抑制發炎因子表達，並激活垂體–腎上腺皮質系統（HPA 軸），同時改善冠狀動脈血流與心肌耗氧狀態，對降低心律失常的誘發因素具有潛在意義。
4.5 多因素、整體性的協同機制
總體而言，針灸對心律失常的調節並非單一路徑，而是透過神經、內分泌與心臟電生理等多層面互相作用，形成一種多靶點、整體性的協同調節機制，這也與中醫「整體觀」「心神同治」的理論相互呼應。
五、討論與未來研究方向
目前研究雖展現正面趨勢，但仍有以下限制：
- 樣本數多偏小，
- 穴位選擇、電刺激參數、療程差異大，
- 缺乏統一的治療方案，
- 長期追蹤數據有限，
- 迷走神經調節效果因人而異。
未來研究可朝以下方向發展：
- 標準化治療方案（穴位、頻率、電刺激參數），
- 心律不整亞型的分層研究，
- 與心臟科合作的多中心隨機對照試驗（RCT），
- 運用心率變異度（HRV）等自律神經指標進行客觀量化，
- 探討針灸與抗心律不整藥物的協同機制。
六、結論
針灸、經皮穴位電刺激與迷走神經刺激等技術，已在現代研究中展現出調節心律、穩定自律神經、改善心悸症狀的潛力。
其作用機制涉及多層次的神經—內分泌—心臟電生理系統，具有多靶點、整體性的優勢。
雖仍需更高質量研究驗證，但現階段可合理將其定位為：心律失常與心悸管理中的重要「輔助療法」與「神經調節工具」。隨著未來更多跨科合作、多中心 RCT 以及 HRV 等客觀指標的應用，針灸在心血管整合醫療中的角色，有望更加清晰而重要。
Hu, A. and Zhang, M. (2023) ‘Research Progress in Acupuncture for the Treatment of Arrhythmias Translation’, Traditional Chinese Medicine (中医学), 12(8), pp. 2413–2418. Available at: https://www.researchgate.net/publication/373410639_Research_Progress_in_Acupuncture_for_the_Treatment_of_Arrhythmias_Translation (Accessed: 22 November 2025).
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