Yoga may help as a complementary treatment for paroxysmal atrial fibrillation

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A randomised controlled study has found that yoga with light movements and deep breathing may lead to improved quality of life, as well as reduced blood pressure and heart rate in patients with paroxysmal atrial fibrillation. The study findings suggest that yoga could be a complementary treatment method to standard therapy.

The 12-week pilot study took place at the Danderyd Hospital, Stockholm, Sweden, and was published in the European Journal of Cardiovascular Nursing. The authors, led by Maria Wahlstrom from the Department of Clinical Sciences, Danderyd Hospital, explain that “one of the most important treatment goals in atrial fibrillation is to reduce symptoms and improve quality of life.” To their knowledge, “this is one of the largest randomised studies evaluating the effect of yoga in patients with paroxysmal atrial fibrillation.” Many previous studies have been small and not randomised, hence the ongoing debate over the efficacy of yoga in improving medical conditions.


Eighty patients with early or newly diagnosed paroxysmal atrial fibrillation were included in the study, providing that they had been on medication for at least three months. Participants were randomised into the yoga group (n=40) and the control group (n=40). The yoga group performed once weekly Mediyoga, a form of yoga “specifically designed for people with cardiac diseases; it includes movements that stretch the muscles in the chest, which facilitates deep breathing and relaxes the body.” Those in the control group were not allowed to perform yoga during the 12-week study period.

The primary endpoint was difference in quality of life after 12 weeks of yoga between the groups and within the groups. The secondary endpoints were blood pressure and heart rate from baseline to the end of the study. Quality of life assessment was based on two questionnaires completed at inclusion and end of study; the Short-Form Health Survey (SF–36) and a VAS-scale from EuroQoL-5D (EQ–5D). The secondary endpoints were also assessed at both visits, following a period of rest.

 

Thirty-three patients completed the yoga intervention, with 36 patients in the control group completing the study period. At baseline, the control group scored significantly higher than the yoga group in both quality of life questionnaires (EQ–5D VAS-scale (p=0.02) and SF–36 mental health score (p<0.001)). According to Wahlstrom et al, this imbalance may have arisen due to the inclusion of more women and patients with a previous stroke/transitory ischaemic attack in the yoga group, as both these factors have led to a poorer estimate of quality of life in previous studies. There were no significant differences between the groups in terms of the SF–36 physiological health scores.

 

Following the intervention, the yoga group averaged higher SF–36 mental health scores (p=0.016), but there were no differences in EQ–5D VAS- scale and SF–36 physiological health score between the two groups.

Within the groups, the estimated scores in EQ–5D VAS-scale had increased significantly (p<0.001) in the yoga group whereas the control group experienced no change (p=0.622). The same pattern was seen in the estimated SF–36 mental health scores, with significant improvement in the yoga group (p<0.001) during the study that was not seen in the control group (p=0.782). The SF–36 physiological health scores showed no differences within the groups at the end of the study. At the end of the study, the yoga group had significantly lower heart rate (p=0.024) and systolic (p=0.033) and diastolic blood pressure (p<0.001) compared to the control group.

 

Wahlstrom et al conclude that yoga improves quality of life and that patients “have a method to gain some self-control over their symptoms.” The improved haemodynamic parameters are also thought to give patients a “feeling of security”. However, it is noted that a larger sample size is needed to confirm the effects of yoga in paroxysmal atrial fibrillation.

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