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. 2021 Oct;11(5):1067-1079.
doi: 10.21037/cdt-21-201.

Acupuncture as an adjunctive therapy for arrhythmia: a Delphi expert consensus survey

Jin-Ling Li #  1 , Li-Qiong Wang #  1 , Na Zhang  1 , Xin-Tong Su  1 , Ying Lin  1 , Jing-Wen Yang  1 , Guang-Xia Shi  1 , Cun-Zhi Liu  1
Affiliations

Acupuncture as an adjunctive therapy for arrhythmia: a Delphi expert consensus survey

Jin-Ling Li et al. Cardiovasc Diagn Ther. 2021 Oct.

Abstract

Background: Current evidence suggests that acupuncture is an effective adjunctive therapy that can bring potential benefits to patients with cardiac arrhythmias. However, there are relevant gaps in the optimal therapeutic strategy, which may cause uncertainties on the best practice of acupuncture treatment for arrhythmia. We aim to develop consensus-based recommendations for clinical guidance on acupuncture treatment of cardiac arrhythmias.

Methods: A multidisciplinary panel of specialists was invited to participate in a two-round semi-open clinical issue investigation. Meanwhile, relevant literature reviews were searched in 3 databases to provide evidence. Subsequently, an initial consensus voting list on acupuncture as an adjunctive therapy for cardiac arrhythmias was derived from the clinical investigation and literature review. Finally, 30 authoritative experts reached a consensus on the key issues of the voting list by a three-round modified Delphi survey. Consensus was defined when >80% agreement was achieved.

Results: Following the three-round Delphi survey, there were 32 items (91.43%) finally reaching consensus, including the following 5 domains: (I) the benefits of acupuncture for the appropriate population; (II) the general therapeutic principle; (III) the acupuncture strategy; (IV) the relevant adverse events; (V) others.

Conclusions: Consensus was achieved on some key elements. Given the lack of guidelines and the substantial heterogeneity of previous studies, these recommendations are of value in providing guidance for clinical practice of acupuncturists and in assisting patients with arrhythmia to obtain standardized acupuncture treatment. It also pointed out some problems that need to be carefully explored in future studies.

Keywords: Acupuncture; Delphi study; adjunctive therapy; cardiac arrhythmia; expert consensus.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/cdt-21-201). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The development process of expert consensus. GRADE, Grading of Recommendations, Assessment, Development, and Evaluation; PICO, population, intervention, control, and outcomes.
Figure 2
Figure 2
Results of the first round of Delphi survey.
Figure 3
Figure 3
Results of the second round of Delphi survey.
Figure 4
Figure 4
Results of the third round of Delphi survey.
See this image and copyright information in PMC

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