Disease and Condition Overview
Arrhythmia is characterized by irregular heart heat, either too fast or too slow. It is often accompanied by palpitations, shortness of breaths, fatigue, and tightness in the chest. In Chinese medicine, it is caused by the stagnation in the heart channel, or qi and blood of the five zang organs not flowing into each other properly.
Clinically, it is often diagnosed by pulse rate, ECG, exercise stress testing.

Pair-point Treatment Combinations

(1) Xinshu (BL15), Juque (RN14) (Fig 82)
Xinshu (BL15): on the back, below the spinous process of the fifth thoracic vertebra (T5), 1.5 cun lateral to the posterior midline.
Juque (RN14): on the upper abdomen, on the anterior midline, 6 cun superior to the umbilicus.
Xinshu (BL15) is the back-shu point of the heart channel. Juque (RN14) is the front-mu point of the heart. This pair point combination, one anterior and one posterior, unobstructs heart collateral, restores the natural rhythm. Appropriate for all types of arrhythmia.

Needling techniques:
1. Xinshu (BL15) perpendicular insertion 1 cun.
2. Juque (RNl4) perpendicular insertion 0.5 cun.
3. Use even method for 10-30 minutes.

(2) Xinshu (BL15), Neiguan (PC6) (Fig 83)
Xinshu (BL15): on the back, below the spmous process of the fifth thoracic vertebra (T5), 1.5 cun lateral to the posterior midline.
Neiguan (PC6): on the palmer side of the forearm, on the line connecting Daling (PC7) and Quze (PC3), 2 cun superior to the wrist crease, between the tendons of m. palmaris longus and m. flexor carpiradialis.
Xinshu (BL15) disperses and opens heart collateral, regulates blood and qi. Neiguan (PC6) soothes the chest and harmonizes and regulates qi, quiets the heart and calms the mind. This pair point combination, both primary and secondary working together to nourish and strengthen heart. Appropriate for all causes of arrhythmia.

Needling techniques:
1. Xinshu (BL15) perpendicular insertion 1 cun.
2. Neiguan (PC6) perpendicular insertion 1 cun.
3. Use even method for 10-30 minutes.

(3) Neiguan (PC6), Jianshi (PC5) (Fig 84)
Neiguan (PC6): on the palmer side of the forearm, on the line connecting Daling (PC7) and Quze (PC3), 2 cun superior to the wrist crease, between the tendons of m. palmaris longus and m. flexor carpi radialis.
Jianshi (PC5): on the palmer side of the forearm, on the line connecting Daling (PC7) and Quze (PC3), 3 cun superior to the wrist crease, between the tendons of m. palmaris longus and m. flexor carpi radialis.
Neiguan (PC6) is the Luo-connecting point of the hand-jueyin channel. Jianshi (PC5) is the xi-cleft point of hand-jueyin channel. This pair point combination quiets the heart and calms the mind, disperses harmonize and regulate qi and blood. Appropriate for arrhythmia caused by qi and blood stagnation.

Needling techniques:
1. Both Neiguan (PC6) and Jianshi (PC5) perpendicular insertion 1 cun.
2. Use even method for 10-30 minutes.

Commentaries
Acupuncture treatment of arrhythmia as definite results. Relatively, it is more effective in treating arrhythmia caused by misfiring of electrical impulses than that of electrical impulses traveling along abnormal pathways.
Especially Neiguan (PC6), Jianshi (PC5), is very effective in treating arrhythmia.
The latter, select Xinshu (BL15), Juque (RN14), or Xinshu (BL15), Neiguan (PC6).
As for serious patients suffering from arrhythmia, it is important to combine other points in treatment.
In addition, patient should avoid stress, emotional distress, and keep a balanced diet.