Wednesday, January 24, 2007

Can We Psyche Ourselves Into Feeling Better?

Vasovagal syncope is one of the causes of sudden episodes of loss of consciousness. One of the mechanisms of passing out is sudden drop in heart rate. In some cases, it can be demonstrated on a test called tilt table test. It was thought- because this problem is caused by low heart rate- why not put pacemakers in these patients so that pacemaker does not let the heart rate drop? This idea looked good on a study called VPS I. Subsequent studies did not show similar benefits.
A recent article in The American Journal of Medicine reviews all the studies that studied the role of pacemaker in case of vasovagal syncope. In some studies, all the study subjects were given pacemakers. The pacemakers were turned on in one group while were turned off in the other group. The research volunteers in both groups felt better. That made the researchers reach a conclusion that pacemaker is likely not of much use in people with vasovagal syncope (passing out episodes).
Why did people who had the pacemaker turned off (hence being same as not having any pacemaker) feel better? The study calls it an ‘expectation’ response. It means, “Patients who have undergone surgical pacemaker implantation might expect to have fewer syncopal recurrences.”
Mind body connection?
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