Acupuncture for paroxysmal and persistent atrial fibrillation: An effective non-pharmacological tool?

Figure 1 Schematic representation of the temporal changes of the factors that favor or oppose to atrial fibrillation. Initial (left side) triggers play a major proarrhythmic role and need to be targeted by therapeutic interventions. With time and the change from paroxysmal to persistent atrial fibrillation (AF), both triggers and structural alterations become critical and both have to be targeted by therapy. Finally, when structural alterations become extensive and not reversible, AF becomes permanent. The timing of this journey varies from patient to patient and is likely to be related to cardiac and non-cardiac factors. RF: Radio frequency; AA: Antiarrhythmic; ACE-I: Angiotensin converting enzyme inhibitor.