Abstract
RATIONALE: Premature ventricular contraction (PVC) is a common type of arrhythmia, and obstructive sleep apnea (OSA) is a common trigger for this condition. Some patients still have PVC, even if ventilation is improved by wearing a respirator. Traditional Chinese medicine (TCM) has a long history of arrhythmia treatment, and this is the first report of a patient with PVC caused by OSA treated with TCM. Twenty-four-hour Holter showed that the number of PVCs decreased from 8968 to 0 before and after TCM treatment, and discomfort symptoms disappeared completely. PATIENT CONCERNS: A 37-year-old middle-aged man, with no history of hypertension, diabetes, hyperlipidemia, or other underlying diseases, had been suffering from OSA for over 1 year and currently uses a respirator to sleep. He was diagnosed with PVC at Beijing Anzhen Hospital 1 year ago and had been taking propafenone hydrochloride tablets following the physician's advice, but palpitation had not been relieved. The patient did not consider surgery and hoped to take TCM to treat the palpitations. DIAGNOSES: The patient was diagnosed with PVC. After excluding other factors that could cause PVC, it was ultimately considered that the patient's PVC was related to OSA. INTERVENTIONS: The patient visited Xiyuan Hospital on December 5, 2023, on the basis of existing Western medicine and TCM, using the modified Huanglian Wendan Decoction. OUTCOMES: After taking TCM for 21 days, the Holter tests were conducted again. The results showed that the number of PVCs decreased from 8968 to 0 within 24 hours. Meanwhile, his palpitations were relieved, and the dosage of propafenone hydrochloride tablets was halved. After 7 days, he did not experience any discomfort; therefore, propafenone hydrochloride tablets were discontinued and TCM was exclusively administered. He received 7 additional courses in TCM. During the final consultation on April 23, 2024, the patient reported no discomfort, and snoring improved. LESSONS: After treatment with TCM, the patient's palpitations disappeared completely and snoring improved, which proved that TCM can treat PVC caused by OSA. To verify this conclusion, more high-quality research is necessary to establish the efficacy and underlying mechanisms of TCM in treating PVC caused by OSA.