Arrhythmias
Also known as: cardiac arrhythmia, heart rhythm disorder, atrial fibrillation, AF, atrial flutter, supraventricular tachycardia, SVT, ventricular tachycardia, ventricular fibrillation, bradycardia, premature atrial contractions, premature ventricular contractions, heart block, long QT syndrome, sick sinus syndrome
Arrhythmias are abnormalities in the rate, rhythm or electrical conduction of the heart. The heartbeat may be too fast, too slow, irregular or intermittently interrupted. Arrhythmias range from harmless premature beats to life-threatening ventricular rhythms. Common examples include atrial fibrillation, atrial flutter, supraventricular tachycardia, premature atrial or ventricular contractions, sinus bradycardia, heart block and ventricular tachycardia. Symptoms may include palpitations, fluttering, skipped beats, chest discomfort, breathlessness, fatigue, dizziness, exercise intolerance, fainting or near-fainting, although some arrhythmias cause no symptoms. Potential causes and contributors include structural heart disease, coronary artery disease, heart-valve disease, thyroid disorders, electrolyte disturbance, sleep apnoea, infection, fever, anaemia, alcohol, stimulants, recreational drugs and medicine effects. Diagnosis may involve electrocardiography, ambulatory monitoring, event recording, blood tests, echocardiography, exercise testing, implantable loop monitoring or electrophysiology studies. Treatment depends on the rhythm and may include observation, treatment of an underlying cause, medicines, anticoagulation, electrical cardioversion, catheter ablation, pacemaker implantation or an implantable cardioverter-defibrillator. Atrial fibrillation increases stroke risk, and anticoagulation decisions require validated clinical risk assessment. Acupuncture and Chinese herbal medicine cannot reliably terminate dangerous arrhythmias, prevent sudden cardiac death, replace anticoagulation or substitute for cardioversion, ablation, pacemakers or defibrillators. Conservative adjunctive care may be considered for anxiety, sleep disturbance or stable symptom burden only after cardiac assessment. TCM patterns historically associated with palpitations include Heart Qi deficiency, Heart Blood deficiency, Heart Yang deficiency, Heart Yin deficiency, Phlegm-Fire disturbing the Heart, Qi stagnation with Blood stasis and Heart-Kidney disharmony.
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Lifestyle & Diet
- •Attend all cardiology, electrophysiology and rhythm-monitoring appointments.
- •Take rate-control, rhythm-control and anticoagulant medicines exactly as prescribed.
- •Do not stop anticoagulants because the heartbeat feels normal or an episode has ended.
- •Do not stop beta blockers, calcium-channel blockers, antiarrhythmics or other cardiac medicines abruptly without medical advice.
- •Seek urgent care for palpitations with chest pain, fainting, severe breathlessness or neurological symptoms.
- •Record the time, duration, symptoms and possible triggers of episodes.
- •Use a medically validated rhythm-monitoring device when recommended.
- •Do not rely solely on a consumer wearable to exclude a dangerous rhythm.
- •Limit excessive caffeine and energy drinks when they trigger symptoms.
- •Avoid cocaine, methamphetamine and non-prescribed stimulant drugs.
- •Discuss alcohol intake with the treating clinician because alcohol may trigger atrial fibrillation.
- •Stop smoking and avoid nicotine overuse.
- •Maintain hydration, particularly during heat, illness or exercise, unless fluid restriction has been prescribed.
- •Seek care for prolonged vomiting or diarrhoea because electrolyte disturbances can provoke arrhythmias.
- •Maintain regular sleep and seek assessment for snoring or possible sleep apnoea.
- •Manage blood pressure, diabetes, thyroid disease, cholesterol and body weight.
- •Follow individual exercise advice and stop activity for chest pain, faintness or unusual breathlessness.
- •Check over-the-counter cold medicines, decongestants, supplements and weight-loss products with a pharmacist.
- •Tell all practitioners about anticoagulants, implanted cardiac devices and previous ablation.
- •Report unusual bruising, black stools, vomiting blood, severe headache or persistent bleeding while anticoagulated.
- •Carry an updated medicine and device list.
- •After device implantation, follow wound, lifting, driving and electromagnetic-exposure instructions.
- •Call triple zero (000) for cardiac arrest, collapse, severe symptoms or stroke signs.
Cautions & Contraindications
- •Do not treat an unstable arrhythmia with acupuncture, herbs, massage, breathing exercises or supplements instead of emergency care.[,]
- •Do not claim acupuncture prevents stroke, cardiac arrest or sudden cardiac death.[]
- •Do not advise stopping anticoagulants because pulse symptoms have improved.[,]
- •Do not advise stopping prescribed rate-control or rhythm-control medicines.[,]
- •Do not perform carotid sinus massage.[]
- •Do not apply electroacupuncture across the chest or near a pacemaker or implantable cardioverter-defibrillator without explicit specialist clearance.[]
- •Do not needle over a cardiac-device pocket or recent catheter-access wound.[,]
- •Do not diagnose the rhythm solely through TCM pulse examination.[,]
- •Do not treat new chest pain as ordinary Qi stagnation.[]
- •Má Huáng and stimulant-containing formulas should generally be avoided because they can increase heart rate and blood pressure.[]
- •Fù Zǐ requires correct processing and is contraindicated in unstable rhythm disorders because of potentially fatal cardiotoxicity.[]
- •Gān Cǎo may cause hypokalaemia, hypertension, fluid retention and arrhythmias, particularly at high doses or with diuretics.[]
- •Dān Shēn, Dāng Guī, Chuān Xiōng, Táo Rén, Hóng Huā and Niú Xī may increase bleeding risk.[]
- •Rén Shēn may interact with warfarin, stimulants, diabetic medicines and cardiovascular drugs.[]
- •Zhǐ Shí and Zhǐ Ké may have cardiovascular and medicine-interaction effects.[]
- •Avoid products containing aconite, ephedra or unverified stimulant ingredients.[]
- •Avoid supplements marketed as natural anticoagulants or rhythm cures without cardiology and pharmacy review.[]
- •Screen all herbs for QT-prolonging potential, electrolyte effects, anticoagulant interactions and liver or kidney impairment.[]
- •Do not interpret syncope, increasing palpitations, chest pain or breathlessness as detoxification or healing.[]
When to reassess or seek care again
- •Reassess symptom pattern, medicine adherence and device status at every visit; escalate any new or worsening cardiac symptom immediately.[,]
- •Refer back to cardiology if arrhythmia frequency, duration or symptom severity changes, or if anticoagulation status is uncertain.[,,]
- •Missed anticoagulant or antiarrhythmic doses
- •Excess caffeine, alcohol, stimulants or recreational drugs
- •Dehydration, illness, fever or electrolyte disturbance
- •Untreated sleep apnoea
- •Emotional stress and poor sleep
Any syncope, chest pain, stroke symptom or ICD shock during care warrants immediate emergency referral rather than continued acupuncture.
Frequently Asked Questions
What is an arrhythmia?+
An arrhythmia is an abnormality in the speed, regularity or electrical conduction of the heartbeat, per Healthdirect Australia [1].
What symptoms can an arrhythmia cause?+
Symptoms may include palpitations, skipped beats, chest discomfort, breathlessness, fatigue, dizziness and fainting [1].
Can an arrhythmia occur without symptoms?+
Yes. Some arrhythmias, including atrial fibrillation, may be detected only during examination or rhythm monitoring [2].
Why is atrial fibrillation important?+
Atrial fibrillation can increase the risk of blood clots and stroke and may require anticoagulation and rhythm or rate management [2,3,5].
When are palpitations an emergency?+
Emergency care is required when palpitations occur with chest pain, severe breathlessness, fainting, confusion, shock or stroke symptoms [1,2].
How are arrhythmias diagnosed?+
Diagnosis may involve an ECG, ambulatory monitor, event recorder, blood tests, imaging and electrophysiology assessment [1,5].
How are arrhythmias treated?+
Treatment may include observation, medicines, anticoagulation, cardioversion, ablation, a pacemaker or an implantable defibrillator [4,5].
Can acupuncture stop a dangerous arrhythmia?+
No. Dangerous arrhythmias require emergency cardiac treatment, and acupuncture must not delay cardioversion or defibrillation [7].
Is acupuncture safe with a pacemaker?+
Manual acupuncture away from the device may sometimes be possible, but electroacupuncture near implanted cardiac devices should generally be avoided without specialist clearance [7].
Can Chinese herbs interact with heart-rhythm medicines?+
Yes. Herbs may affect heart rate, blood pressure, potassium, anticoagulation, medicine metabolism and QT interval [7].
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- Healthdirect Australia · 2026
- Healthdirect Australia · 2026
- Heart Foundation Australia · 2026
- Heart Foundation Australia and Cardiac Society of Australia and New Zealand · 2018
- European Society of Cardiology · 2024
- World Health Organization · 2008
- World Health Organization · 2020
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.