Issue 25-3, 2026

Original article

https://doi.org/10.38025/2078-1962-2026-25-3-57-66

Effect of Acu-TENS on Autonomic Cardiac Regulation After Open Heart Surgery: A Randomized Controlled Study

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ORCIDHaidy M. El-Mesallamy*, ORCIDZeinab M. Helmy, ORCIDAyman S. Gado, ORCIDEl-Sayed E.E. Felaya

Cairo University, Giza, Egypt


ABSTRACT

INTRODUCTION.Cardiac autonomic nervous system (ANS) dysfunction is a common and clinically significant complication in patients undergoing open heart surgery (OHS). In traditional Chinese medicine, the pericardium meridian is considered essential in regulating cardiovascular function. Stimulation of specific acupoints along this meridian may modulate cardiovascular responses and reduce the physiological stress associated with surgery.

AIM.To evaluate the effects of acupuncture transcutaneous electrical nerve stimulation (Acu-TENS) on heart rate variability (HRV) indices and functional capacity in patients after OHS.

MATERIALS AND METHODS.Forty patients (aged 40–65 years) of both sexes who underwent OHS were enrolled in a randomized controlled trial. Participants were randomly assigned to two groups (n = 20 each). Group A received Acu-TENS in addition to the standard postoperative medical and physiotherapy program. Group B received only the conventional medical and physiotherapy regimen. Dependent variables assessed pre- and post-intervention included heart rate (HR), RR interval, standard deviation of normal-to-normal interbeat intervals (SDNN), HRV index, low-frequency to high-frequency (LF/HF) ratio, Borg scale ratings, 6-minute walk test (6MWT) distance, and percentage of predicted walking distance.

RESULTS.Both groups showed improvements, but Group A had significantly greater changes. Group A showed reduced HR (p = 0.001) and LF/HF ratio (p = 0.032), and increased HRV index (p = 0.045), RR interval (p = 0.010), SDNN (p = 0.002), 6MWT distance (p = 0.025) and percentage of predicted percent (p = 0.034). No significant difference in Borg scale scores was observed (p = 0.321).

DISCUSSION.Both grouped showed statistically significant improvement across all dependent variable measured post rehabilitation program, autonomic regulation following following acupuncture at the PC6 acupoint is thought to be mediated through cardiac cholinergic pathways, resulting in suppression of sympathetic activity and reduction of elevated heart rate.

CONCLUSION.Postoperative Acu-TENS enhanced autonomic recovery, improved HRV indices, augmented hemodynamics, and increased functional capacity in patients after OHS supporting its consideration as an adjunct to standard physical therapy rehabilitation post-open-heart surgery protocols.


KEYWORDS: acupuncture transcutaneous electrical nerve stimulation (Acu-TENS), autonomic heart rate variability, functional capacity, open heart surgery

FOR CITATION: El-Mesallamy H.M., Helmy Z.M., Gado A.S., Felaya E.E.E. Effect of Acu-TENS on Autonomic Cardiac Regulation After Open Heart Surgery: A Randomized Controlled Study. Bulletin of Rehabilitation Medicine. 2026; 25(3):57–66. https://doi.org/10.38025/2078-1962-2026-25-3-57-66

FOR CORRESPONDENCE:

Haidy Mustufa El-Mesallamy, E-mail: haidyssmustufa@cu.edu.eg


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.