Results of a Swedish study support the physiologic and psychological benefits of regular yoga practice for patients with AF.
As the burden of atrial fibrillation (AF) increases with the aging population and the stress of daily life continues to deepen in Western society, patients and providers often begin to wonder about the use of alternative therapies to improve quality of life (QOL) in this chronic disease.
A small pilot study (N=80) from Stockholm randomized patients to standard treatment or standard treatment plus a 12-week yoga program (called MediYoga ). Yoga sessions included deep breathing, stretching, and meditation.
Patients were included if they had AF requiring pharmacologic intervention and excluded if language or medical barriers prevented full participation in and compliance with a prescribed yoga regimen. The study reported QOL outcomes as well as physiologic parameters, such as heart rate and blood pressure. Despite the control group having a higher QOL score at the beginning of the study, the yoga group had a higher average mental health score (on the SF-36 mental health survey) and lower heart rate and blood pressure values compared with the control group at the end of the study. Note that, despite being randomized, the yoga group had more women at baseline and more patients with prior stroke.
This is one of the largest randomized studies to date reporting the effects of an alternative therapy such as yoga on QOL in patients with paroxysmal AF. The mechanisms of these positive physiologic effects remain unclear. However, one may hypothesize that decrease in blood pressure or stimulation of the vagal response can both contribute positively to a sense of well-being. Given its small size, however, its conclusions should be interpreted with caution. Furthermore, the patients cannot be blinded to treatment so the beneficial effect of yoga on QOL could be a placebo effect or due less to yoga therapy and more to the benefit of a group therapy setting.
Regardless, I think this study opens the door for providers to discuss alternative therapies with patients as part of a comprehensive treatment regimen for AF.
Wahlstrom M, Karlsson MR, Medin J, et al. Effects of yoga in patients with paroxysmal atrial fibrillation-a randomized controlled study.European J Cardiovasc Nursing 2016; DOI: 10.1177/1474515116637734.