Atrial fibrillation (AF) is a common cardiac rhythm disturbance, rising in prevalence with age. An estimated 2.5 million people in North America and 4.5 million in Europe are attacked by AF, which is responsible for largish morbidity and mortality. Although radiofrequency and cryo-ablation therapy have been widely used in the management of AF, antiarrhythmic drugs remain as the first-line therapy for rhythm control of AF [
- Chugh S.S.
- Havmoeller R.
- Narayanan K.
- Singh D.
- Rienstra M.
- Benjamin E.J.
- et al.
Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study.
Circulation. Feb 25 2014; 129: 837-847
2]. Wenxin Keli (WXKL) is a traditional Chinese herb extract with anti-arrhythmic effects, which is composed of five components: Nardostachys chinensis Batal extract (NcBe), Codonopsis, Notoginseng, amber, and Rhizoma Polygonati. In clinical practice, WXKL can markedly improve the patients' symptoms including palpitations, chest tightness, fatigue, insomnia, and others and that it have significant effects on ameliorating different types of arrhythmias including atrial and ventricular premature contractions and sinus tachycardia [
- Ferrari R.
- Bertini M.
- Blomstrom-Lundqvist C.
- Dobrev D.
- Kirchhof P.
- Pappone C.
- et al.
An update on atrial fibrillation in 2014: from pathophysiology to treatment.
Int. J. Cardiol. Oct 18 2015; 203: 22-29
- Hua W.
- Gao R.L.
- Zhao B.C.
- Wang J.
- Chen X.H.
- Cai C.
- et al.
The efficacy and safety of Wenxin Keli in patients with frequent premature ventricular contractions: a randomized, double-blind, placebo-controlled, parallel-group, multicenter trial.
Chin. Med. J. 5th Oct 2015; 128: 2557-2564
4]. Previous study [
- Brenyo A.
- Aktas M.K.
Review of complementary and alternative medical treatment of arrhythmias.
Am. J. Cardiol. Mar 1 2014; 113: 897-903
] has shown that Wenxin Keli suppressed early after depolarizations (EADs), delayed after depolarizations (DADs), and triggered ventricular arrhythmias through selective inhibition of late INa that is proved to contribute to arrhythmogenesis. Also, Xing et al. [
- Xue X.
- Guo D.
- Sun H.
- Wang D.
- Li J.
- Liu T.
- et al.
Wenxin Keli suppresses ventricular triggered arrhythmias via selective inhibition of late sodium current.
Pacing Clin. Electrophysiol. Jun 2013; 36: 732-740
] demonstrated that WXKL prevented heart failure and cardiac arrhythmias through a potential mechanism involving the regulation of the CaMKII signal transduction pathway. WXKL has been found to inhibit the Ca2+ transient amplitude in ISO-stimulated cardiac myocytes, WXKL increased both the sarcoplasmic reticulum (SR) Ca2+ content and the calcium transient amplitude in isolated cardiac myocytes from rats with myocardial infarction, while also significantly decreased the incidence of EADs and DADs in these isolated cardiac myocytes. In addition, WXKL markedly reduced the incidence of cardiac arrhythmias in vivo rat myocardial infarction model.
- Xing Y.
- Gao Y.
- Chen J.
- Zhu H.
- Wu A.
- Yang Q.
- et al.
Wenxin-Keli regulates the calcium/calmodulin-dependent protein kinase II signal transduction pathway and inhibits cardiac arrhythmia in rats with myocardial infarction.
Evid. Based Complement. Alternat. Med. 2013; 2013: 464508
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- Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study.Circulation. Feb 25 2014; 129: 837-847
- An update on atrial fibrillation in 2014: from pathophysiology to treatment.Int. J. Cardiol. Oct 18 2015; 203: 22-29
- The efficacy and safety of Wenxin Keli in patients with frequent premature ventricular contractions: a randomized, double-blind, placebo-controlled, parallel-group, multicenter trial.Chin. Med. J. 5th Oct 2015; 128: 2557-2564
- Review of complementary and alternative medical treatment of arrhythmias.Am. J. Cardiol. Mar 1 2014; 113: 897-903
- Wenxin Keli suppresses ventricular triggered arrhythmias via selective inhibition of late sodium current.Pacing Clin. Electrophysiol. Jun 2013; 36: 732-740
- Wenxin-Keli regulates the calcium/calmodulin-dependent protein kinase II signal transduction pathway and inhibits cardiac arrhythmia in rats with myocardial infarction.Evid. Based Complement. Alternat. Med. 2013; 2013: 464508
- Atrial-selective inhibition of sodium-channel current by Wenxin Keli is effective in suppressing atrial fibrillation.Heart Rhythm. 2012 Jan; 9: 125-131
- The Chinese herb extract Wenxin Keli: atrial selectivity from the far east.Heart Rhythm. 2012 Jan; 9: 132-133
- Wenxin Keli suppresses atrial substrate remodelling after epicardial ganglionic plexi ablation.Exp. Clin. Cardiol. Spring 2013; 18: 153-157
- The effects of wenxin keli on p-wave dispersion and maintenance of sinus rhythm in patients with paroxysmal atrial fibrillation: a meta-analysis of randomized controlled trials.Evid. Based Complement. Alternat. Med. 2013; 2013: 245958
- Wenxin Keli versus sotalol for paroxysmal atrial fibrillation caused by hyperthyroidism: a prospective, open label, and randomized study.Evid. Based Complement. Alternat. Med. 2015; 2015: 101904
Published online: October 27, 2015
Accepted: October 26, 2015
Received: October 24, 2015
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.