A Prayer of Healing
by Joan Naidorf DO
I was admitting an older man, a local pastor, with new onset of atrial fibrillation. The fibrillating atrium is an inefficient place where harmful blood clots can form. While we were working him up, his heart rhythm was monitored. I could watch his rhythm on a centralized monitor near my work space in the center of the emergency department.
I noted that my patient had visitors at the bedside. They were chatting for a while then I noticed them move. One person on each side of the gurney joined hands with the patient and each other. My patient, who had been reclining, leaned forward, and bowed his head in prayer. As I watched this very sweet scene, I noticed something remarkable on the monitor. After a slight pause, a little P wave appeared in front of every QRS complex. He had converted from atrial fibrillation to a normal sinus rhythm!
I walked quickly to his room and told him, “You converted!” He sensed by my smile that this was something good and he asked, “What does that mean?” I explained what it meant and auscultated his regular heart sounds. We repeated the EKG to confirm the rhythm change and to check for any signs of ischemia. All was good and he needed to complete a work-up.
Why did it happen? Was his prayer answered? More likely, when the gentleman leaned forward in the gurney to pray, he forced a strong Valsalva maneuver. A Valsalva maneuver forces expiration against a closed glottis. The maneuver increases intrathoracic pressure, leading to the reduction of preload to the heart. In some people, this maneuver alone is sufficient to slow down or convert an abnormal rapid rhythm.
A believer might say that the Lord answered his prayers. If I hadn’t witnessed this unusual coincidence, I would question the whole story. My patient converted from atrial fibrillation to sinus rhythm during a moment of prayer. Was it prayer, the act of prayer, or some mysterious and fortuitous combination of both?
Dr. Joan Naidorf is an emergency physician, author and speaker located in Alexandria, VA.
Her book, “Changing How we Think About Difficult Patients: a Guide for Physicians and Healthcare Professionals,” is published by the American Association for Physician Leadership.