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Ablation for Atrial Fibrillation: A Placebo?

Atrial fibrillation (AF) is an irregular and often rapid heart rate that can increase your risk of stroke, heart failure, and other heart-related complications. During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly—out of coordination with the two lower chambers (the ventricles) of the heart. Atrial fibrillation symptoms often include heart palpitations, shortness of breath, and weakness. Doctors believe some factors that can contribute to atrial fibrillation include obesity, sleep apnea, alcohol, high blood pressure, inflammatory conditions (infections and trauma), excessive exercise, and stress. I would add to that repressed anger and rage (TMS). Episodes of atrial fibrillation can come and go (just like episodes of recurrent Back Pain), or you might develop atrial fibrillation that doesn’t go away (just like chronic back pain) and might require treatment. Although atrial fibrillation itself usually isn’t life threatening, it is a serious medical condition that sometimes requires emergency treatment. How is AF treated? If medication fails, one of the most common invasive treatments is ablation. During an ablation, the doctor destroys tiny areas in the heart that are firing off abnormal electrical impulses and causing atrial fibrillation. What’s interesting is that after twenty years of treating AF with ablation, it was recently determined that, just like back surgery for back pain, it is no better than a placebo. In his commentary “Could Ablation for AF Be an Elaborate Placebo?,” John Mandrola, MD, discusses the latest findings on the ineffectiveness of ablation. He also points out, “The truth is we lack a true scientific understanding of what causes the arrhythmia, and we have little basic scientific insights into what is fibrillation itself.” As I write in Rapid Recovery from Back and Neck Pain, we still lack a true scientific understanding of what causes back pain, unless we take into account the mind-body connection. Dr. Mandrola also points out other invasive procedures that are no better than a placebo: “Transmyocardial revascularization (drilling holes in the heart), pacing for hypertrophic cardiomyopathy, and ligation of coronary arteries were practices that required the courage of sham controls to be proven ineffective.” Of course, this is also the case for back surgery. So always ask to see the research for surgical procedures. And if you are ever diagnosed with AF, it is a good idea to avoid ablation. Dr. Mandrola says, “Not only are the results poor, but the procedure is big—ablation lesions in the left atrium, often millimeters away from the esophagus or phrenic nerve, general anesthesia, transseptal puncture, multiple vascular entries, and hours of bed rest put patients at significant risk. Creating scar to treat a disease that is often caused by scar hardly seems elegant.” Stay informed. Stay well.

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