Yoga as Heart Therapy

People assume that yoga is healthy for body and mind … and there’s ample evidence favoring that proposition.

When it comes to heart disease, yoga’s effects on stress and certain specific risk factors suggest that it should be helpful.

But rigorous, controlled clinical trials testing the effects of yoga, tai chi, and similar body-mind disciplines are not easy to conduct.

As of 2012, only six peer-reviewed trials testing the effects of yoga on coronary heart disease (CHD) outcomes had been published.

Last year, Hong Kong researchers reviewed those trials, and expressed reason for optimism: “Lifestyle modifications play an important role in secondary prevention [of CHD]. Growing evidence suggests the beneficial effects of yoga on various ailments.”

The Chinese team reviewed the trials to judge the influence of yoga on the risk of adverse CHD outcomes (e.g., heart attacks, stroke, irregular heart rhythms, and death).

Unfortunately, their review found the evidence too thin to allow a firm conclusion: “The effectiveness of yoga for secondary prevention in CHD remains uncertain. Large RCTs [randomized controlled trials] of high quality are needed.” (Lau HL et al. 2012)

We hope that other researchers take that plea to heart, and get the funds needed to conduct larger trials. But for now, there is some very good news about yoga and one important aspect of heart health.

Yoga eased heartbeats and raised moods and quality of life

Novel clinical findings show that yoga can halve episodes of irregular heartbeat in heart patients diagnosed with atrial fibrillation.

Better yet, daily yoga sessions significantly improved the patients’ quality of life and the symptoms of anxiety and depression often associated with atrial fibrillation.

The trial focused on people diagnosed with atrial fibrillation (AF) … a rapid, disorganized heartbeat that causes the upper chambers of the heart (atria) to contract abnormally.

This common heart rhythm disorder is a leading cause of stroke and can lead to sudden cardiac death (SCD), although SCD is usually triggered by unsteady rhythms in the lower heart chambers (ventricular fibrillation).

Atrial fibrillation affects some 2.5 million Americans and is often triggered by emotional or work-related stress. Symptoms include chest pains, dizziness, palpitations, fatigue, and shortness of breath.

People with AF frequently require medication and/or invasive treatment.

“The practice of yoga is known to improve many risk factors for heart disease, including high blood pressure, high cholesterol, hardening of the arteries, and stress and inflammation in the body,” said lead investigator Dhanunjaya Lakkireddy, M.D.

And as he noted, “There are currently no proven complementary therapies that are known to help decrease the symptoms of atrial fibrillation in a noninvasive fashion with minimal side effects and reasonable safety and efficacy.” (UKH 2013)

Integrative physician Jeanne Drisko, M.D., and arrhythmia expert Lakkireddy lead Yoga My Heart … a study of yoga’s effect on cardiac arrhythmia, which tracks patients with irregular heart rhythms as they practice yoga.

Dr. Lakkireddy hopes yoga may provide a noninvasive, medication-free treatment option. “Yoga provides a powerful connection between mind and body … [it’s] unique in that it affects heart rhythm through its significant influence on the central and autonomic nervous systems.”

“Atrial fibrillation is one of those arrhythmias that are critically dependent on the communication between the heart and the brain,” he added (UKH 2013).

More than a half-dozen drugs are used to treat atrial fibrillation, but they don’t always work and can lose effectiveness. A heart procedure that destroys electrical hot spots works about 75 percent of the time.

Details of the Yoga My Heart trial

Dr. Lakkireddy’s team at The University of Kansas Hospital followed 49 patients with atrial fibrillation (symptomatic paroxysmal AF) who had no physical limitations (Lakkireddy D et al. 2013).

The volunteers wore a portable heart monitor to record episodes of atrial fibrillation during the six months of the trial.

During the first three months – the “control” phase – participants were permitted to engage in any customary exercise or other activities, other than yoga.

This phase was followed by a three-month “intervention” phase where patients participated in a supervised yoga program consisting of breathing exercises, postures, meditation, and relaxation.

Throughout this phase, a certified yoga instructor led the volunteers in two 60-minute yoga sessions per week.

Participants were also given an educational DVD and encouraged to practice the exercises at home daily.

All the participants were new to yoga, and progressed safely from basic movements to more advanced practice over the course of the study.

Compared with the control phase – where people did the physical activity of their choice – the number of episodes of irregular heart beat fell by half during the yoga “therapy” phase.

After the yoga phase, the patients also showed healthier scores on tests for depression and anxiety.

Finally, the yoga phase produced higher scores on quality of life measures, including physical capacities, general health, vitality, social engagement, and mental health.

As Dr. Lakkireddy said, “These findings are important because many of the current conventional treatment strategies for atrial fibrillation include invasive procedures or medications with undesirable side effects.

Success with these therapies varies widely, and they are often only modestly effective in controlling heart rhythm.” (UKH 2013)

“It appears yoga has a significant impact on helping to regulate patients’ heart beat and improves their overall quality of life,” he added. “Any intervention that helps in reducing or controlling the arrhythmia burden in atrial fibrillation can have a huge impact on public health.” (UKH 2013)

Given the low cost, safety and effectiveness of yoga, the authors recommend considering it in the overall strategy for treating atrial fibrillation and other heart rhythm disorders.

Sources
Lakkireddy D, Atkins D, Pillarisetti J, et al. 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. Published online January 30, 2013. doi:10.1016/j.jacc.2012.11.060. Accessed at http://content.onlinejacc.org/article.aspx?articleid=1567301
Lau HL, Kwong JS, Yeung F, Chau PH, Woo J. Yoga for secondary prevention of coronary heart disease. Cochrane Database Syst Rev. 2012 Dec 12;12:CD009506. doi: 10.1002/14651858.CD009506.pub2.
University of KansasHospital (UKH). First Ever Yoga Study Published in the Journal of the American College of Cardiology Finds Yoga to be a Safe, Effective Therapy for Heart Patients. January 31, 2013. Accessed at http://www.kumed.com/newsroom/news/published-study-finds-yoga-safe-effective-therapy-for-heart-patients

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