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Background  The previous study showed that the cardiac arrhythmias induced by myocardial ischemia and reperfusion were attenuated by the pretreatment of acupuncture; however, the related mechanism is not understood. The present study was therefore designed to determine whether intracellular Ca 2+  ([Ca 2+ ] i ) and connexin 43 (Cx 43 ) are involved in the mediation of the anti-arrhythmic effect of electro-acupuncture (EA) pretreatment in the rats subjected to simulative global ischemia and reperfusion (SGIR).    Methods  SGIR was made in the isolated heart by a low flow perfusion followed by a flow restoration. Four groups of animals are involved in the present study, including normal control group, SGIR group, EA group and EA plus 18 beta-glycyrrhetinic acid (EAG) group. For EA pretreatment, bilateral Neiguan acupoints (PC6) of the rats were stimulated for 30 min once a day in 3 consecutive days. Cx 43  antagonist was given to the rats in EAG group 30 minutes before the EA pretreatment. The resting [Ca 2+ ] i  concentration, calcium oscillation, the contents of total Cx 43  and non-phosphrylated Cx 43  and arrhythmia score were compared among different groups.    Results  In EA group, the arrhythmic score, the resting [Ca 2+ ] i  concentration and the number of [Ca 2+ ] i  oscillations were all significantly less than those in SGIR group (all  P  < 0.05), and interestingly, after EA pretreatment, the contents of nonphosphated Cx43 in the EA group were significantly lower than that in SGIR group respectively ( P  < 0.05). However, when the rats were treated with Cx 43  antagonist prior to the EA pretreatment, the protection effects induced by EA pretreatment were reversed.    Conclusions  The results showed that EA pretreatment could produce anti-arrhythmic effect in the rats subjected to SGIR. The anti-arrhythmic effect of EA pretreatment may be due at least partially to the inhibition of SGIR-induced calcium overload and [Ca 2+ ] i  oscillations, reduction of non-phosphorylated Cx 43  and the enhancement of the corresponding phosphorylated Cx 43  in the cardiac cells.    Electronic supplementary material  The online version of this article (doi:10.1186/s12906-015-0521-y) contains supplementary material, which is available to authorized users.

bmc complementary and alternative medicine

Anti-arrhythmic effect of acupuncture pretreatment in the rats subjected to simulative global ischemia and reperfusion—involvement of intracellular Ca2+ and connexin 43