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Similarities between the renal artery and pulmonary vein denervation trials: Do we have to use sham procedures for atrial fibrillation catheter ablation trials?

      Placebo and nocebo effects have recently emerged as an interesting model to understand some of the intricate underpinnings of the mind–body interaction [
      • Frisaldi E.
      • Piedimonte A.
      • Benedetti F.
      Placebo and nocebo effects: a complex interplay between psychological factors and neurochemical networks.
      ]. The human healing process can be substantially influenced in actual medical practice by appropriate kinds of caring, communication, and patient empowerment [
      • Moerman D.E.
      • Jonas W.B.
      Toward a research agenda on placebo.
      ]. The latest scientific evidence has demonstrated, however, that the placebo effect and the nocebo effect, the negative effects of placebo, stem from highly active processes in the brain [
      • Enck P.
      • Benedetti F.
      • Schedlowski M.
      New insights into the placebo and nocebo responses.
      ]. Two theories have been proposed to explain the placebo effect: the conditioning theory, which states that the placebo effect is a conditioned response, and the mentalistic theory, which sees the patient's expectation as the primary cause of the placebo effect. Expectations can affect heart rate, blood pressure, coronary diameter, gastric motility, bowel motility, and lung function [
      • Olshansky B.
      Placebo and nocebo in cardiovascular health: implications for healthcare, research, and the doctor-patient relationship.
      ,
      • Meissner K.
      Placebo responses on cardiovascular, gastrointestinal, and respiratory organ functions.
      ]. Although there are countless historical and contemporary examples of the impressive placebo effect in procedures such as surgery or chiropractic [
      • Cho H.J.
      Reviving the old sermon of medicine with the placebo effect.
      ,
      • Benedetti F.
      Placebo and the new physiology of the doctor-patient relationship.
      ], the placebos have long been considered a nuisance in basic research and particularly in clinical research in modern medicine. However, today they represent an active and productive field of research in different systems, medical conditions, and therapeutic interventions [
      • Benedetti F.
      • Carlino E.
      • Pollo A.
      How placebos change the patient's brain.
      ]. In cardiology, placebos influence disability, syncope, heart failure, atrial fibrillation, angina, and survival [
      • Olshansky B.
      Placebo and nocebo in cardiovascular health: implications for healthcare, research, and the doctor-patient relationship.
      ].

      Keywords

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