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J Chiropr Med. 2011 Jun;10(2):130-4. doi: 10.1016/j.jcm.2010.09.002. Epub 2011 Apr 5.

Chiropractic care of a patient with thoracic outlet syndrome and arrhythmia.

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  • 1Professor, Palmer College of Chiropractic, Port Orange, FL; Chiropractor, Private Chiropractic Practice, Port Orange, FL.



The purpose of this article is to describe a case report and discuss a possible anatomical explanation of the occurrence of arrhythmias in patients with thoracic outlet syndrome (TOS).


A 60-year-old man experienced arrhythmia when he turned his head to the left and had these symptoms for 7 years. The patient attributed his symptoms to TOS. The arrhythmia was triggered while performing an Adson test during the clinical evaluation.


The Grostic procedure as a measure of analysis of the biomechanical relationship of C1 to C0 and the lower cervical spine was performed. According to this analysis, the patient had a right laterality malposition of the atlas. High-velocity, low-amplitude manipulations (adjustments) were applied. The patient's symptoms improved after one visit and demonstrated resolution upon evaluation at the third visit. In the year following the initial presentation, he has had minor recurrent short-lived episodes of arrhythmia that abated with the atlas manipulation/adjustment.


There is a paucity of published reports describing the management of patients with arrhythmias through manipulative methods. This appears to be the first case that describes the successful amelioration of an arrhythmia associated with TOS using chiropractic adjustment of the atlas vertebra as the sole intervention.

Copyright © 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

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