Purpose: To provide scientific support, through an extensive review of the literature, for the hypothesis that cardiac symptoms and specifically Atrial Fibrillation (AFib) may arise due to problems in the cervical and or thoracic spine. Studies strongly indicate the presence of thoracic outlet syndrome (TOS) as a prime culprit for perturbations causing interference with the nerves (TOSn), arteries (TOSa), and veins (TOSv) that all affect the healthy function of the cardiovascular system. We will examine multiple causes for AFib and illustrate how the ANS and TOS plays a role in this aetiology.
Methods: Analysis was undertaken of the literature reporting on atrial fibrillation as well as its related conditions such as ventricular tachycardia, mitral valve prolapse, and postural orthostatic tachycardia syndrome (POTS). Most studies published are based on single clinical case studies or small cohort studies.
Conclusions: It is reported here that there is a strong apparent connection between TOS and ANS perturbations and AFib. Furthermore, considering the reporting that there is a five times greater risk factor for stroke among patients with AFib, it would appear that Chiropractic in its approach to AFib could be a therapy that might prove to be beneficial in avoidance of stroke. This, together with other interventions that target the ANS, might present an avenue of intervention that could provide the patient with viable options when other treatments fail to resolve the condition. It could as well provide the physician with another tool with which to evaluate and screen patients. Further studies with larger cohorts are necessary to obtain more significant patient data to confirm aetiology.
Indexing terms: Chiropractic; spinal adjustment; thoracic outlet syndrome (TOS); vagal nerve; dysautonomia; Atrial Fibrillation; Postural orthostatic tachycardia syndrome (POTS); stroke
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