Patterns of Heart Rate Variability Changes Induced by Electroacupuncture: A Scoping Review of Stimulation Frequency and Duration

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Objectives: This scoping review aimed to systematically examine the reporting patterns of heart rate variability (HRV) changes following electroacupuncture (EA) stimulation, specifically focusing on frequency and duration parameters.Methods: A comprehensive literature search was conducted in PubMed (MEDLINE) and via manual screening from inception to October 2025. Studies reporting quantitative HRV outcomes in humans following EA intervention were included. Two independent reviewers screened the literature and extracted data based on the Population, Concept, and Context (PCC) framework.Results: A total of 20 studies were included. Regarding frequency, low-frequency EA (≤10 Hz) was the most studied parameter (12 studies), with 8 studies (66.7%) reporting a significant increase in parasympathetic activity or improved autonomic balance. In contrast, high-frequency (≥50 Hz) and mid-frequency (11-49 Hz) stimulation showed mixed results, including sympathetic activation or rebound effects during the recovery phase. Regarding duration, stimulation for less than 30 minutes (especially 15-20 minutes) was frequently associated with favorable HRV changes, particularly in the post-stimulation recovery phase.Conclusions: This review identified reporting patterns suggesting that low-frequency EA (≤10 Hz, particularly around 2 Hz) and shorter durations (<30 minutes) are associated with enhanced parasympathetic tone, often manifesting as delayed effects during the post-stimulation recovery phase, whereas higher frequencies (≥15 Hz) or prolonged stimulation (≥30 minutes) showed tendencies toward sympathetic activation. Given the considerable heterogeneity in current studies, future rigorous research with standardized protocols is needed to establish optimal EA parameters for specific clinical populations.

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