Abstract
OBJECTIVE: To reevaluate systematic reviews and Meta-analysis (SR/MAs) on the efficacy and safety of acupuncture in treating arrhythmias. METHODS: SR/MAs of acupuncture treatment for arrhythmias were retrieved from four English databases (PubMed, Embase, Web of Science, Cochrane Library) and four Chinese databases ?(China National Knowledge Infrastructure? Database, China Science and Technology Journal Database, Wanfang Data and Chinese Biomedical Literature Database) up to December 2023. Data were extracted according to predefined criteria. The methodological quality of included SR/MAs was assessed using the A Measurement Tool to assess systematic Reviews 2, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Grading of Recommendations, Assessment, Development, and Evaluation were used to assess the reporting quality and evidence quality of the included SR/MAs. RESULTS: A total of 10 SR/MAs were included, involving 8 types of arrhythmias (atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, atrial premature beat, ventricular premature beat, sinus tachycardia, sinus bradycardia, and sick sinus syndrome) and 10 outcome indicators. The evaluation of efficacy and safety showed that acupuncture can effectively improve the average heart rate and clinical efficacy of patients with various types of arrhythmias, reduce the number of premature beats in patients with premature beats based on 24-h dynamic electrocardiography, increase the rate of sinus rhythm conversion in patients with atrial fibrillation, shorten the time to convert to sinus rhythm, etc., without serious adverse reactions. The results of methodological quality, reporting quality, and evidence quality of the included SR/MAs showed that the methodological quality evaluation was very low; reporting quality evaluation included 5 items rated as "somewhat deficient" and 5 items rated as "relatively complete"; evidence quality evaluation included 0 items rated as high, 4 items rated as medium, 13 items rated as low, and 17 items rated as very low. CONCLUSION: Acupuncture as an adjuvant treatment for arrhythmias is clinically effective. However, due to the low quality of existing evidence, further improvement in the quality of original research design and SR/MAs is needed to provide strong scientific evidence and clear conclusions.