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Chiropractic Research Review

Can Cervical Manipulation End Arrhythmia?

Lesions in the brain and nervous system can induce cardiac arrhythmia, although problems in the hearts electrical conduction system are a more common cause. When arrhythmia presents in otherwise healthy patients, the etiology may be unknown, and clinicians are often reluctant to provide diagnostic or therapeutic recommendations because of possible iatrogenic risks.

It has been reported in some cases that patients experience complete resolution of arrhythmia after spinal manipulation. The subject of this case report is an example of resolution after spinal manipulation, recorded in a clinical setting. A 23-year-old man demonstrated bradycardia, a slow heart rate, and an abnormal heart rhythm on his electrocardiogram (ECG). The subject was fit and otherwise asymptomatic, but 24-hour ECG monitoring confirmed the arrhythmia.

Cervical palpation revealed a substantial hypertonicity to the right of the C2 spinous process and a rotary restriction at that vertebral level. Pressure applied to the right articular pillar of C2 during right anterior rotation generated more resistance than the same procedure performed to the left side. A single supine cervical rotary adjustment was performed using a high-velocity, low-amplitude thrust; no other therapy was used. Continuous ECG monitor ing before, during, and after manipulation revealed that the abnormal rhythm completely disappeared coincident with the manipulative maneuver. ECG recordings four and seven days later showed that the trigeminal rhythm was still absent. The patient's bradycardia was unaffected by the procedure.

Conclusion: "While it is not possible to prove cause and effect from a single case study, the temporal relationship of events in this incidence argues strongly that the resolution of the trigeminal rhythm was due to spinal manipulation," the authors suggest.

Budgell BS, Igarashi Y. Response of arrhythmia to spinal manipulation: Monitoring by ECG with analysis of heart-rate variability. Journal of the Neuromusculoskeletal System 2001:9(3), pp. 97-102.

Chiropractic Research Review

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