Yoga Reduced Arrhythmias in Paroxysmal AF



NEW ORLEANS – Practicing yoga can significantly reduce irregular heart beat episodes and improve symptoms of anxiety and depression in patients with paroxysmal atrial fibrillation, according to a study of 49 patients.

“This drives home the point that yoga used as a supplement and complement to existing therapies could make a dramatic difference in the quality of life of people, bring down anxiety and bring down arrhythmia burden in a cumulative fashion,” said Dr. Dhanunjaya Lakkireddy, lead author and associate professor of medicine at University of Kansas Hospital, Kansas City, at the annual scientific sessions of the American College of Cardiology.

Previous research has shown that heart failure patients can benefit from yoga, and that it yoga has a positive impact on overall health of various types of patients, including those with cancer. But this is the first study to examine the benefits of yoga on patients with atrial fibrillation, said Dr. Lakkireddy and his coinvestigators. “Atrial fibrillation is the bane of cardiologists’ existence,” and the condition also interferes with patients’ lives, leading to anxiety and depression. “It also consumes a lot of health care dollars,” he said.

What prompted Dr. Lakkireddy to conduct the study was seeing the progress in one of his patients who practiced yoga regularly.

Dr. Janet Wright, senior vice president of science and quality at ACC, said that the study was suggested by a patient, and commended Dr. Lakkireddi for “listening to patients and to what works for them, and equipping patients with things they can do to self manage their chronic conditions.”

The investigators conducted a prospective, self-controlled, single-center study on 49 patients with atrial fibrillation who had no physical limitations. For the first 3 months, the control phase, the patients were allowed to engage in their previous physical activities. During the following 3 months, the intervention phase, the patients participated in a supervised yoga program (B.K.S. Iyengar’s conventional yoga program), which included breathing exercises, yoga postures, meditation and relaxation, for an average of 45 minutes, three times a week. They were also given an educational DVD to continue practice at home, depending on their comfort level. All participants were new to yoga.

Episodes of irregular heartbeat were measured during the 6-month study period with portable monitors and patient logs. Patients also completed surveys on anxiety, depression and quality of life.

Episodes of arrhythmia episodes decreased, from a mean of 3.8% in the control phase to 2.1% in the interventional phase. Likewise, asymptomatic episodes came down from 2.6 to 1.4 episodes, while quality of life improved: patients’ anxiety score decreased by 4 points, and their depression score by 5 points. All these differences were statistically significant, said Dr. Lakkireddy.

Here we have another piece of data showing the importance of stress and anxiety on atrial fibrillation events,” said Dr. Ralph Brindis, president of ACC. “The fact that yoga may decrease atrial fibrillation burden is fascinating. I am convinced totally that stress reduction technique would be an important armament for patients for minimizing atrial fibrillation burden and more importantly improving their quality of life.”

Dr. Lakkireddy speculated that yoga affects cardiac autonomic tone by creating a flattening effect and preventing abnormal surges in the autonomic nervous system. Stress and inflammation also play a role in atrial fibrillation, he said. “Yoga improves all of these things.”

The authors said that yoga can be considered in the treatment strategy for atrial fibrillation and other complex heart rhythm disorders, given that it is noninvasive, low cost, “with minimal side effects and reasonable safety and efficacy.” Dr. Lakkireddy said he prescribes yoga to his patients with atrial fibrillation. However, “yoga does not treat atrial fibrillation,” he stressed.

One of the main limitations of the study is the small number of participants, said Dr. Lakkireddy, adding that more research with a larger number of patients is needed.

Dr. Lakkireddy had no disclosures. “I practice yoga. That’s my only disclosure,” he said.

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