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Electroacupuncture for slow flow/no-reflow in patients with acute myocardial infarction undergoing percutaneous coronary intervention: a pilot randomized controlled trial.

Frontiers in cardiovascular medicine·March 2026·Xuqiang Wei, Yanbin Peng, Ke Wang et al.
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Key Finding

Intraoperative electroacupuncture at PC6 and PC4 significantly reduced the incidence of slow flow/no-reflow during PCI for acute myocardial infarction from 26.7% in controls to 6.7% in the treated group (RR 0.2; P=.04).

What This Means For You

A heart attack is a terrifying event, and the procedure used to restore blood flow to the heart — called percutaneous coronary intervention, or PCI — can sometimes run into a serious complication known as "slow flow" or "no-reflow." This happens when blood still struggles to reach the heart muscle even after the blocked artery is opened, and it can worsen recovery outcomes. It affects up to 44% of PCI procedures performed during a heart attack.

Researchers in China wanted to know whether electroacupuncture — a form of acupuncture that uses gentle electrical stimulation through the needles — could help prevent this complication. In a small pilot trial, 60 patients having PCI for a heart attack were randomly assigned to either receive electroacupuncture during their procedure or have the procedure alone. The acupuncture needles were placed at two well-known heart-related acupoints on the wrist and forearm called Neiguan (PC6) and Ximen (PC4).

The results were encouraging. In the electroacupuncture group, only 2 out of 30 patients (6.7%) experienced slow flow or no-reflow, compared to 8 out of 30 patients (26.7%) in the standard care group. Patients who received electroacupuncture also reported significantly less chest pain and anxiety both immediately after the procedure and 12 hours later. Additionally, inflammatory markers in the blood were lower in the electroacupuncture group at the 12-hour mark, suggesting the treatment may help calm the body's inflammatory response after a heart attack. No side effects were reported.

While this was a small, single-center study and larger trials are still needed, these findings suggest that electroacupuncture could be a safe and helpful addition to standard heart attack care. If you are interested in how acupuncture might support your cardiovascular health, speak with a licensed acupuncturist who has experience working alongside medical teams.

Clinical Notes for Practitioners

This single-center, assessor-blinded pilot RCT (n=60) evaluated intraoperative electroacupuncture (EA) at PC6 and PC4 as an adjunct to PCI in AMI patients. EA significantly reduced the incidence of slow flow/no-reflow (SF-NR) versus control (6.7% vs. 26.7%; RR 0.2, 95% CI 0.0–0.4; P=.04). Patient-reported pain (NRS) and anxiety (VAS-A) were significantly lower at 0h and 12h post-PCI (both P<.001). EA was also associated with attenuation of early inflammatory markers at 12h, including leukocytes, neutrophils, and hs-CRP (all P<.05). No significant differences were observed in cardiac biomarkers or 30-day MACCE, though a trend favored EA (16.7% vs. 36.7%; P=.09). No adverse events occurred. Clinical takeaway: EA at pericardium channel points during PCI shows a promising signal for reducing microvascular obstruction and systemic inflammation. Larger multicenter, sham-controlled trials are warranted before clinical integration.

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