Patients with atrial fibrillation (AF) often have an impaired quality of life (QoL) and face depression and anxiety. Little information is available on alternative forms of therapy for AF in comparison to treatments such as antiarrhythmic drugs and catheter ablations. The impact of one complementary form of therapy, yoga, in patients with AF has not yet been studied. This single-center study reports, for the first time, that yoga improves symptoms, arrhythmia burden, heart rate, blood pressure, anxiety and depression scores, as well as several areas of quality of life in patients with paroxysmal AF.

Forty nine patients between the age of 18 and 80 with paroxysmal AF completed this study. The study consisted of two phases: the control (first 3 months) and yoga intervention (next 3 months). During the intervention phase, patients attended Iyengar yoga training at least twice weekly, with each session lasting 60 minutes. The class was taught by a certified yoga instructor and consisted of pranayamas, warm-up exercises, asanas, and ended with relaxation exercises. Primary outcomes of the study included change in symptomatic AF episodes, symptomatic non-AF, and asymptomatic AF episodes. These primary outcomes were monitored using self-reporting through a symptom diary and a cardiac non-looping event monitor. Secondary outcomes included change in the Short Form 36 (SF-36) QoL score, Zung self-assessment anxiety score (SAS) and Zung self-assessment depression score (SDS).

The study showed that yoga significantly reduced the number of symptomatic AF episodes, symptomatic non-AF episodes and asymptomatic AF episodes from the end of the control phase to the end of the yoga intervention phase. In addition, by the end of the intervention phase, the SDS and SAS scores improved significantly and the SF-36 scores improved in the areas of physical functioning, general health, social functioning, and mental health. By the end of the control phase both heart rate and systolic and diastolic blood pressures decreased from baseline. The study also found that there was a correlation between the hemodynamic variables, arrhythmia, and outcomes; the decrease in heart rate after yoga may be related to improvement in anxiety shown through changes in SAS scores. In addition, improvement in the QoL, anxiety and depression scores may be due to the idea that yoga helps to create a neurohormonal balance in the body in response to stress.

This study is the first to research the effects of yoga as an additional and alternative therapy for AF. It shows that practicing yoga can reduce AF episodes, in addition to improving hemodynamic variables and QoL, anxiety and depression scores in patients with AF. In summary, the YOGA My Heart study demonstrates that yoga is an effective noninvasive complementary therapy for the reduction of atrial fibrillation burden and consequences.

Reference: 1. Lakkireddy D, Atkins D, Pillarisetti J, Ryschon K, Bommana S, Drisko J, Vanga S, Dawn B. Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: the YOGA My Heart Study. J Am Coll Cardiol. 2013 Mar 19;61(11):1177-82.