Yoga could reduce the burden and symptoms of atrial fibrillation as well as medication related side effects and the complications with cardiac ablation

Background

Atrial fibrillation (AF) is a common cardiac arrhythmia that affects around three million people worldwide. Thromboembolic stroke, myocardial ischemia and congestive heart failure with significant financial burden are bad outcomes of AF. It is associated with significant morbidity and is also an independent risk factor for mortality. The treatment of AF and its associated complications increases healthcare resource utilization and contributes to increasing costs of healthcare, particularly costs associated with recurrent hospitalization.

Methods

538 patients of atrial fibrillation are enrolled in our multicentric study from 2012 to 2017 that brought to light the therapeutic impact a noninvasive, medication-free intervention has on a costly disease.The unique approach of this study involved patients serving as their own controls; for the first 12 weeks, patients continued standard AF medical or catheter ablation therapy, followed by 16 weeks of 30-min alternate day yoga sessions (Savasana / Sun Salution Yoga Posture, Ujjayi Breath and Anulom –Vilom Pranayam). Patients were also encouraged to practice yoga at home on a daily basis.We divided into two group Yoga and Non Yoga and compared the data after 16 weeks of training.

Results

Yoga training reduced symptomatic AF episodes (14.8±4 vs. 8.2±3.2, p<0.005), symptomatic non-AF episodes (12.8±2.8 vs. 9.2±2.2; p<0.004), asymptomatic AF episodes (2.4±0.4 vs. 1.3±0.20; p<0.005), and depression and anxiety (p<0.005) used Goldberg anxiety score 2.5 fold improved as compared to non yoga group while improving, QoL parameters including physical functioning, vitality, social functioning, and mental health as assessed using the SF-36 (p=0.017, p<0.001, p<0.001, p=0.019, and p<0.003, respectively). There were significant decreases in heart rate and systolic (11±3 mmhg) and diastolic (6±2 mmhg) blood pressure after yoga training (p<0.002). This may directly result in decreased hospitalization (38% in yoga vs 16% in non yoga group) and healthcare costs reduction in yoga group. Yoga is also an intervention free from medication-related side effects or the complications observed with cardiac ablation.

Conclusions

The primary outcome was a composite of the reductions in symptomatic AF, symptomatic non-AF, and asymptomatic AF episodes as recorded by a diary and correlated with a non-looping event monitor with low cost. Strikingly, the results validate the ability of yoga practice to reduce patient-reported AF symptoms. It also demonstrated a statistically significant impact on quality of life (QoL), mental health, physical functioning, depression, and anxiety with avoid of side effects of medication or ablation.

Funding Acknowledgement

Type of funding source: None

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