A Case Report of Arrhythmia Patient with Palpitations and Dyspnea Improved by Complex Korean Medicine Treatment Including Hyungbangdojeok-san (荊防導赤散, Jīngfángdáochì sán)

Objectives: This case report demonstrates the clinical effect of Hyungbangdojeok-san (HBDJS) for arrhythmia, assessed using a 72-h Holter monitor and heart rate variability (HRV) analysis.Case Presentation: A man in his late 40s presented with palpitations, globus pharyngeus, and shortness of breath persisting for over five years, worsened by stress and fatigue. Conventional antiarrhythmic agents were poorly tolerated due to side-effects. Initial HRV analysis showed elevated sympathetic activity and reduced parasympathetic activity (SDNN 26.6 ms, RMSSD 15.5 ms, LF/HF ratio 6.8). A 72-h Holter ECG recorded 4 premature ventricular contractions (PVCs) and 36 premature atrial contractions (PACs), all isolated and asymptomatic. The patient received HBDJS for 19 weeks combined with nonpharmacological traditional Korean medicine (TKM) interventions. By day 132, symptoms markedly improved: numeric rating scale scores 5-8 to 0. Follow-up Holter showed 17 PVCs and 23 PACs without arrhythmogenic runs, confirming improvement without cardiac deterioration.Conclusions: This case highlights the potential of TKM, including HBDJS, as a safe and effective approach for managing arrhythmia in patients who are unable to tolerate conventional therapies, thereby improving quality of life through integrative care.