Home›Drug Pipeline› Yangxin Dingji plus conventional therapy reduces 6-month atrial fibrillation recurrence and improves LVEF
Yangxin Dingji plus conventional therapy reduces 6-month atrial fibrillation recurrence and improves LVEFYangxin Dingji Combined With Standard Care Shows Promise for Atrial Fibrillation
Frontiers in MedicinePublished October 16, 2026DOI ↗Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development
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Key Takeaway
Note that Yangxin Dingji may reduce 6-month AF recurrence and improve LVEF, but evidence quality is limited.
This meta-analysis evaluated the efficacy of Yangxin Dingji (YXDJ) combined with conventional therapy compared to conventional therapy alone in patients with atrial fibrillation. The analysis included 872 patients and assessed various clinical and physiological outcomes, including recurrence rates, symptom scores, and inflammatory markers.
Key findings included a significant improvement in the overall clinical response rate (RR = 1.27, P < 0.00001) and a reduction in EHRA symptom scores (MD = -0.47, P = 0.0009). Notably, the recurrence of atrial fibrillation at 6 months was reduced (RR = 0.43, P = 0.03). Physiological improvements were noted in LVEF (MD = 4.39%, P < 0.00001) and LAEF (MD = 2.11%, P = 0.003). Additionally, inflammatory markers such as hs-CRP, TNF-alpha, and IL-6 showed significant reductions.
The authors noted several limitations, including the inclusion of methodologically limited, small, and single-center Chinese studies. There was also a lack of blinding for subjective outcomes and inadequate allocation concealment. Most efficacy outcomes were supported by low- or very-low-certainty evidence, while LVEF and 6-month recurrence were of moderate certainty. These findings provide preliminary signals for symptom control and postoperative management but should not replace guideline-directed therapy.
How this fits prior evidence
This meta-analysis addresses a gap in the management of atrial fibrillation symptoms and postoperative outcomes. While prior evidence highlights the role of superior vena cava isolation to reduce tachyarrhythmia recurrence and the use of vascular closure devices to reduce hemostasis time, this study explores the role of Yangxin Dingji as an adjunctive therapy. The findings regarding reduced recurrence and improved LVEF provide preliminary data for complementary management, but do not replace established guidelines for anticoagulation or rhythm control.
Researchers analyzed data from 872 patients with atrial fibrillation to see how adding the herbal formula Yangxin Dingji (YXDJ) to standard medical care affected heart health. The study looked at several factors, including patient symptoms, heart function, and the likelihood of the heart rhythm returning after surgery.
The findings showed that patients who received both standard care and Yangxin Dingji had better clinical response rates and lower symptom scores. Additionally, the study noted a reduction in the recurrence of atrial fibrillation at six months. Some measurements of heart function, such as the left ventricular ejection fraction, also showed improvement in the group receiving the combined treatment.
It is important to note that much of this evidence is based on small, single-center studies and is considered to have low or very low certainty. Because the data is preliminary, Yangxin Dingji should not be used as a replacement for standard medical treatments like anticoagulation or rhythm control. Patients should consult their doctors to discuss how these findings might relate to their specific treatment plan.
What this means for you:
Yangxin Dingji may help manage symptoms and reduce recurrence in atrial fibrillation, but evidence is still preliminary.
Common questions
Can Yangxin Dingji help with my heart symptoms?
The study found that patients who took Yangxin Dingji along with standard treatment reported lower symptom scores and better overall clinical response rates. However, because the evidence is based on small studies and is considered preliminary, it is not a replacement for your current doctor-prescribed treatment plan.
Does it help prevent the heart rhythm from coming back?
The analysis showed a reduction in the recurrence of atrial fibrillation at the six-month mark for those using the combination of Yangxin Dingji and standard care. This finding was noted as having moderate certainty, but you should discuss this specific result with your healthcare provider.
Is it safe to use this treatment?
The study reported no clear increase in the overall incidence of adverse events for those taking Yangxin Dingji. However, the study was limited by small sample sizes and a lack of some trial details, so you should always consult your doctor before adding any new supplement to your routine.
BackgroundYangxin Dingji Capsule (YXDJ), a modern Chinese patent medicine derived from the classic Zhigancao Decoction, is commonly used as an adjuvant therapy for atrial fibrillation (AF). This study aimed to comprehensively evaluate the efficacy and safety of YXDJ as an adjuvant therapy in AF patients.Materials and MethodsWe systematically searched PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine, Wanfang, VIP Chinese Journal Service Platform, and China National Knowledge Infrastructure from inception to 1 April 2026, for randomized controlled trials (RCTs) comparing YXDJ plus conventional therapy versus conventional therapy alone in patients with AF. Meta-analyses were performed using RevMan with fixed- or random-effects models based on heterogeneity. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the overall quality of evidence for each outcome was evaluated using the GRADE framework. The protocol was registered in PROSPERO (CRD420261286691).ResultsTen RCTs involving 872 patients were included. All studies were Chinese-language publications with methodological limitations. According to the RoB 2 assessment, most studies were rated as having some concerns or high risk of bias, mainly due to inadequate allocation concealment, lack of blinding for subjective outcomes, and absence of publicly available trial registrations or protocols. In terms of clinical symptoms, YXDJ was associated with improvements in the overall clinical response rate [RR = 1.27, P < 0.00001, very low], reductions in EHRA symptom scores [MD = −0.47, P = 0.0009, very low], and reductions in postoperative AF recurrence at 6 months [RR = 0.43, P = 0.03, moderate]. For cardiac function, YXDJ was associated with increases in left atrial ejection fraction (LAEF) [MD = 2.11%, P = 0.003, low] and left ventricular ejection fraction (LVEF) [MD = 4.39%, P < 0.00001, moderate], whereas no significant changes were observed in left atrial diameter (LAD) [MD = −1.97 mm, P = 0.07, very low] and mitral E/A ratio [MD = 0.12, P = 0.06, very low]; subgroup analysis revealed that YXDJ reduced LAD in postoperative patients [MD = −2.70 mm, P = 0.02, low]. In terms of inflammatory biomarkers, YXDJ was associated with reductions in hs-CRP [MD = −1.21 mg/L, P < 0.00001, low], TNF-α [SMD = −0.44, P = 0.0009, low], and IL-6 [MD = −10.42 ng/L, P < 0.00001, low]; subgroup analysis further showed a greater reduction in hs-CRP in postoperative patients [MD = −1.42 mg/L, P < 0.00001, low]. For safety, no clear increase in the overall incidence of adverse events was observed [RR = 0.58, P = 0.07, low]. Exploratory analyses from single studies suggested possible long-term benefits, including a lower reported risk of ischemic stroke and sustained reductions in AF recurrence and symptom scores at 9 months post-ablation; however, these findings are preliminary and require confirmation.ConclusionCurrent evidence, derived exclusively from methodologically limited, small, single-center Chinese studies, provides only preliminary signals that YXDJ may offer possible additional benefits as an adjunct to conventional therapy for symptom control and postoperative management in AF. Most efficacy outcomes were supported by low- or very-low-certainty evidence, with only LVEF and postoperative AF recurrence at 6 months rated as moderate certainty. These findings should be regarded as exploratory and hypothesis-generating. YXDJ should not replace guideline-directed anticoagulation, rate or rhythm control, or catheter ablation. Rigorously designed trials are needed to confirm its efficacy and safety.Systematic ReviewIdentifier CRD420261286691.
