Application of Traditional Chinese Medicine in Treatment of Atrial Fibrillation

Table 1

Application of single CHMs or bioactive ingredients in AF.

Original plant	Medicinal part	Bioactive ingredient	Methods of study	Result	Mechanism	Effect on the four principles of AF
Berberis vulgaris L.	Root	Berberine	Cellular study (rat and human atrial cells)	Vasodilation, positive ionotropic and negative chronotropic actions	Inhibition of Ito by binding to open state channels or shifting of the steady-state inactivation curve of Ito [7]	Rate and rhythm control management of primary disease and risk factors
	Root	Berberine	Animal study (rabbit)	Suppressing AF	Inhibiting Ito [7], prolonging ERP and APD [14]	Rhythm control
	Root	Berberine	Cellular study (guinea pig cardiac myocytes)	Multichannel ion blocker	Inhibiting KATP [15], IKV [16], IKCa [16], IK1, and IK [17]
Saussurea involucrata (Kar. Kir.) Sch. Bip.	Flower [19, 21], root [20]	Sesquiterpene lactone fraction [20]	Animal study (rat)	Anti-inflammatory and analgesic effects [19–21]	Stabilization of lysosomal membranes and an antiproliferative effect [20], preventing accumulation of inflammatory cells [21]	Management of risk factors
	Flower	Acacetin	Animal study (dog)	Suppressing AF	Inhibition of Kach, Kur, and Ito as an atrial-selective agent, prolonging APD and ERP without prolonging the corrected QT interval [8]	Rhythm control
Crataegus rhipidophylla Gand.	Flower heads	Catechin and epicatechin	Cellular study	Antiplatelet aggregation	Inhibiting the biosynthesis of thromboxane A2 [12]	Antithrombotic therapy
	Fruit	Extract (containing flavonoid and procyanidin)	Cellular study (guinea pig ventricular myocytes)	Antiventricular arrhythmia	Prolonging the APD through blocking the delayed (IK) and inward (IK1) rectifier potassium currents [22]
	Fruit	LI 132 (Faros® 300, CRA) [26], WS 1442 [24, 25]	Animal study (Wistar rats heart) [23] and isolated hearts (guinea pig) [26], clinical research [24, 25]	Positive ionotropic action, improving exercise capacity and decreasing mortality in heart failure patients [23–26]	Increasing Ca (2+)-concentration intracellularly [23], increasing cardiac contractility with prolongation of the effective refractory period [26]	Management of primary disease
	Fruit	Epicatechin, hyperoside, and fluid extract	Cellular study (DPPH and ABTS techniques)	Antioxidant activity [29, 30]		Management of risk factors
Corydalis turtschaninovii Besser	Tuber	Rotundium	Clinical research (AF patients)	Suppressing AF	Prolonging the ERP of atrial and atrioventricular node [33]	Rhythm control
	Tuber	D-Corydaline, d-glaucine, protopine, and l-tetrahydrocolumbamine	Animal study (rat)	Antiplatelet aggregation [34]		Antithrombotic therapy
	Tuber	Pseudocoptisine	Cellular study (RAW 264.7 murine macrophage cells)	Anti-inflammatory	Reducing levels of iNOS, COX-2, necrosis factor-alpha (TNF-alpha), and IL-6 through the inhibition of nuclear factor kappa B (NF-kappaB) activation via the suppression of ERK and p38 phosphorylation [9]	Management of risk factors
Leonurus cardiaca L.	Aerial parts	Primary and refined extracts	Cellular and organ studies (rabbit, rat, and guinea pig)	Decreasing the blood pressure, heart rate and increasing coronary blood flow and treating ventricular or sinus tachyarrhythmias [37]	Inhibiting the inward calcium (ICaL) and potassium (IKr) channels, lengthening Q-T, P-Q intervals and the activation time constant of I (f) in pacemaker cells [37, 38]	Rate control and management of risk factors
	Aerial parts		Clinical research	Fibrinolysis effect and antiplatelet aggregation	Decreasing blood viscosity, fibrinogen volume and increasing the deformability of Rbc [39]	Antithrombotic therapy
	Aerial parts	Rutin and derivatives of hydroxycinnamic acid	Cellular study	Antioxidant activity [10, 11, 29, 30, 40]		Management of risk factors