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. 2015 Feb 5;15:5. doi: 10.1186/s12906-015-0521-y

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© Gao et al.; licensee BioMed Central. 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Hypothetical diagram showing the possible targeted points mediating the anti-arrhythmic effect of EA pretreatment. During MIR both sympathetic nervous system (SNS) and β-adrenoceptors (β-AR) were over excited, which leads to intracellular calcium ([Ca²⁺]_i) overload and [Ca²⁺]_i oscillations; in addition, MIR also causes the reduction of total and phosphorylated Cx₄₃, which subsequently attenuates the intercellular electric conductance and the cardiac electric synchronicity. Both the reduction of cardiac electric synchronicity and enhancement of [Ca²⁺]_i oscillations which is known to be related to early and delayed afterdepolarization can result in cardiac arrhythmias. On the one hand, repetitive electro-acupuncture (EA) pretreatment may finally produce the anti-arrhythmic effect via inducing an adaptation of β-AR to the stimulation of catecholamine released from the terminals of SNS, and bringing about the inhibition of both [Ca²⁺]_i overload and [Ca²⁺]_i oscillations; on the other hand, EA pretreatment may also inhibit the MIR-induced reduction of total or phosphorylated Cx₄₃, which consequently enhances the cardiac electric synchronicity and then diminishes the occurrence of arrhythmias.