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The Acute Physiologic Effects of Osteopathic Manipulative Treatment in Patients with Cardiac Implantable Electronic Devices: A Randomized Controlled Trial

Journal: Heart Rhythm Date: 2023/05, 20(5):Pages: S258. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.heartrhythmjournal.com/article/S1547-5271(23)01013-5/fulltext)

Keywords:

blood pressure [35]
cardiac implantable electronic device [2]
conference abstract [108]
heart rate variability [38]
OMT [2951]
osteopathic manipulative treatment [2973]
physiology [30]
randomized controlled trial [710]

Abstract:

Background: Osteopathic manipulative treatment (OMT) is a procedure used to improve physiologic function and maintain homeostasis. OMT modulates the autonomic nervous system (ANS) and augments heart rate variability (HRV) in healthy subjects. The acute physiologic effects of OMT have been reported in patients with heart failure, but not in those with cardiac implantable electronic devices (CIEDs). Objective: To assess the short-term physiologic effects of OMT on heart rate, respiratory rate, arterial blood pressure, and HRV in patients with CIEDs. Methods: Cardiac patients with CIEDs at an osteopathic medical center were recruited into a randomized controlled trial (ClinicalTrials.gov ID: NCT0400474) and assigned to either OMT or light touch (control) groups. Short-term physiologic data was recorded pre and post intervention (including one minute HRV via photoplethysmography). HRV was calculated using root mean square of successive RR interval differences (RMSSD). Student’s t-test was used to compare groups; p < 0.05. Results: 20 subjects were enrolled (10 OMT/10 control). Table 1 shows physiologic measurements prior to and post intervention. Changes in HR, RR, BP, and SpO2 were no different between groups before and after intervention; OMT HRV decreased by 12.39 + 34.05 ms, whereas control HRV increased by 19.94 + 18.54 ms (p=0.022). Conclusion: There was a significant decrease in HRV in the OMT group, but no difference in the remaining standard physiologic variables. The difference in HRV is opposite of what would be expected, and could be due to the effects of OMT on the ANS, altered cardiac response in this population, and possibly a decrease in ectopy. Further evaluation of CIED data (arrhythmias, HRV and activity level) may be helpful in determining the long-term effects of OMT on cardiac arrhythmia patients. [Formula presented]


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