Arrhythmia is a common cardiovascular disease with many complications and high risks, which can cause sudden onset and sudden death, and can also continue to affect the heart and cause heart failure, and its treatment has always been the focus of medical research. There are many traditional antiarrhythmic drugs, but they have not yet achieved the desired effect, and there are common adverse reactions, which is difficult to use for a long time. In recent years, with the deepening of related research, the innovative drug Ginseng Song Yangxin Capsule developed under the guidance of network disease theory has shown the advantages of "integrated regulation, fast and slow treatment", and provides a new treatment plan for the prevention and treatment of arrhythmia.
During the 11th China Congress of Integrative Medicine Angiology, Yimaitong invited Professor Cao Kejiang from the First Affiliated Hospital of Nanjing Medical University to conduct an exclusive interview on the latest research progress of arrhythmia and other topics, in order to bring certain guiding value to clinical practice. Professor Cao Kejiang said that based on the SS-AFRF study and the results of previous studies, Ginseng Song Yangxin has the potential to be used as a broad-spectrum anti-arrhythmic drug, which can bring more benefits to the majority of arrhythmia patients.
Professor Cao Kejiang
The SS-AFRF study was published in the European Heart Journal, filling the gap of drug maintenance of sinus rhythm after ablation
On August 24, 2024, the "Multicenter, randomized, double-blind, placebo-controlled clinical study of the prognosis of patients with atrial fibrillation after radiofrequency ablation (SS-AFRF study)" led by Professor Huang He's team from the People's Hospital of Wuhan University was published online in the European Heart Journal.
The SS-AFRF study included a total of 920 patients with persistent atrial fibrillation (PerAF) after first radiofrequency ablation from 66 hospitals in 24 provinces/municipalities in China between November 2019 and October 2021. All patients were randomly divided into the ginseng song Yangxin group (4 capsules of ginseng song Yangxin capsules, 3 times a day) and placebo group in a 1:1 ratio. The follow-up observation time was 1 year. The primary endpoint of the study was the incidence of recurrent atrial tachyarrhythmias lasting ≥ 30 seconds after a blank period; Secondary endpoints include time to first documentation of atrial tachyarrhythmias, atrial fibrillation burden (cumulative duration of all episodes of atrial fibrillation on 24-hour Holter monitoring), rate of electrical cardioversion, incidence of stroke/systemic embolic events, changes in echocardiographic parameters, and changes in quality of life scores.
The results of 1-year follow-up showed that compared with the control group, the Shensong Yangxin group improved the event-free survival rate of patients with persistent atrial fibrillation (85.5% vs. 77.7%, P=0.001), reduced the recurrence rate of atrial fibrillation after radiofrequency ablation by 7.8%, and reduced the risk of recurrence by 40.0% (HR=0.6, 95%CI: 0.4-0.8). In terms of secondary endpoint outcomes, compared with the control group, the Shensong Yangxin group significantly reduced the burden of atrial fibrillation at 3 and 6 months after radiofrequency ablation (2.8% vs. 7.6%, P=0.002 vs. 3.3% vs. 7.7%, P=0.025). In terms of quality of life, the Ginseng Song Yangxin Group can significantly improve the quality of life of patients and achieve both physical and mental scores.
Professor Cao Kejiang said that the European Heart Journal is a top journal in the field of cardiovascular diseases in the world, mainly publishing high-quality clinical and scientific research in the field of cardiovascular diseases, aiming to create an academic journal with high academic level, strong readability and global influence, which is closer to clinical practice and has a high academic reputation and international influence.
"The SS-AFRF study was published in the European Heart Journal, which has attracted wide attention and recognition from the international academic community, and has far-reaching clinical significance." Professor Cao Kejiang said that the SS-AFRF study not only demonstrates the great potential of traditional Chinese medicine in the field of arrhythmia treatment, but also represents China's scientific research strength in the cardiovascular field, fills the gap of drug maintenance of sinus rhythm after radiofrequency ablation of atrial fibrillation, and takes a solid step for traditional Chinese medicine to go global.
Integrated regulation, fast and slow treatment, ginseng pine and heart can be used as a broad-spectrum anti-arrhythmic drug
As early as 2006, Professor Cao Kejiang diagnosed and treated two patients with bradycardia after bypass, and the effect was obvious after the use of ginseng pine to nourish the heart, and the patients recovered well. On this occasion, Professor Cao Kejiang developed a strong interest in ginseng pine and gradually carried out a number of researches.
The results of the randomized, double-blind, placebo parallel-controlled, multi-center clinical study on the treatment of sinus bradycardia with premature ventricular contractions led by Professor Cao Kejiang and jointly carried out by 30 hospitals across the country showed that compared with the control group, Ginsengsong Yangxin could effectively reduce the number of 24-hour premature ventricular contractions in patients, improve the overall effective rate at 8 weeks of treatment (64.02% vs. 34.34%, P<0.0001), and significantly increase the 24-hour mean ventricular rate at 4 weeks and 8 weeks. In addition, at 4 and 8 weeks of treatment, the clinical symptoms and quality of life of the patients in the Shensong Yangxin group were also significantly improved compared with those in the control group.
A multicenter, randomized, double-blind, placebo parallel-controlled study led by Professor Huang Congxin of the People's Hospital of Wuhan University confirmed that Ginseng Song Yangxin Capsule in the treatment of heart failure complicated with premature ventricular contractions confirmed that Ginseng Song Yangxin can increase the left ventricular ejection fraction (LVEF), improve cardiac function classification, reduce the concentration of N-terminal brain natriuretic peptide precursor (NT-proBNP), increase the 6-minute walking distance, and improve the quality of life of patients. At the same time, the number of 24-hour ventricular premature decline was significantly reduced, and the rate of 24-hour preventricular decline was significantly increased. Studies have shown that ginseng pine nourishing heart can reduce the occurrence of premature ventricular occurrence while improving cardiac function, and has a good safety profile.
In addition, a multicenter, randomized, double-blind, placebo-controlled clinical study of 1476 patients with arrhythmias (859 patients with premature ventricular fibrillation, 349 cases with paroxysmal atrial fibrillation, and 268 cases with bradyarrhythmia) showed that the total treatment efficiency of premature ventricular treatment with ginseng song was better than that of mexiletine; The efficacy in the treatment of paroxysmal atrial fibrillation is comparable to that of propafenone; The overall effective rate of bradyarrhythmia was higher than that of the control group, which could increase the ventricular rate of bradyarrhythmia patients by an average of 7.15 beats/minute.
In 2019, the project "Construction of Traditional Chinese Medicine Context Theory and Its Guidance for the Prevention and Treatment of Microvascular Lesions", which focuses on the research related to ginseng pine and heart nourishment, won the first prize of the only National Science and Technology Progress Award in the field of life sciences in 2019. Professor Cao Kejiang said that it is very difficult to win this award, which proves the important value and scientific basis of ginseng song Yangxin in the field of arrhythmia treatment, provides new drugs for cardiac insufficiency with premature ventricular function, and fills the gap in the treatment of sinus bradym with early, fast and slow ventricular and integrated conditioning drugs.
epilogue
The chain of cardiovascular events proposed by Professor Braunwald, an expert in cardiology in United States, covers the continuous development process from a variety of risk factors (such as hypertension, diabetes, hyperlipidemia, etc.) leading to arterial endothelial damage, atherosclerosis, and then to coronary heart disease events, arrhythmias, heart failure and even death. Professor Cao Kejiang said that the proposal of this concept provides a new perspective and method for the prevention and treatment of cardiovascular diseases.
A number of evidence-based studies have shown that ginseng pine nourishing heart has both efficacy and safety in the treatment of arrhythmia, bringing new treatment options for the majority of arrhythmia patients. In particular, the results of SS-AFRF were published in top international cardiovascular journals, which confirmed that ginseng pine nourishing heart can significantly reduce the risk of recurrence after radiofrequency ablation in patients with persistent atrial fibrillation, providing a solution with Chinese characteristics for international problems in the cardiovascular field, and also promoting the process of traditional Chinese medicine to the international stage.