Yoga may have positive effect on anxiety, depression, arrhythmia burden

Boston AF Symposium

BOSTON — Patients with atrial fibrillation who practice yoga appear to be less anxious and depressed and have an overall better quality of life, a speaker said at the 17th Annual Boston Atrial Fibrillation Symposium.

“Emotional stress is very well correlated with AF. A lot of patients with AF complain of significant anxiety and depression, Dhanunjaya Lakkireddy, MD, director of the Center for Excellence in AF and EP Researcher at the University of Kansas, told Cardiology Today. “However, it is unclear whether anxiety and depression bring on the AF or if AF brings on the anxiety and depression.”

Dhanunjaya Lakkireddy

During a session here, Lakkireddy presented unpublished data from a study that measured quality of life, anxiety and depression in patients with AF. The study included 49 patients who participated in two 60-minute yoga sessions a week for 3 months. Researchers measured quality of life, anxiety and depression scores at baseline and again at the end of 3 months. Additionally, yoga reduced symptomatic AF episodes from 3.8 at baseline to 2.9 at 3 months. The number of asymptomatic AF episodes was also reduced after yoga practice, Lakkireddy said. Yoga was also associated with improved quality of life, anxiety and depression scores at the end of the study period. Correlation analysis showed that change in anxiety and depression correlated with the change in the number of AF episodes.

“There was a 35% to 40% reduction in the number of AF episodes in this study,” Lakkireddy said in an interview. “Yoga doesn’t completely cure AF, but in gross terms, the number of AF episodes was significantly lowered to reach statistical significance.”

The full data are pending publication.

Some of the positive benefits of yoga that occurred in patients with AF could be explained by improvements in resting heart rate and systolic and diastolic blood pressure; change in BP seemed to influence change in AF episodes, Lakkireddy said.

AF is a manifestation of improper interplay between the brain autonomic nervous system and the heart. When a patient experiences negative emotions or stress, the nondominant side of the brain is activated and initiates or triggers a series of events that result in nonhomogeneous, abnormal activations of autonomic components. Nonphysiological changes in the sympathetic and parasympathetic tones are known to initiate AF episodes, Lakkireddy said.

Previous published research has shown that a relaxing activity, such as yoga, can decrease the effects of stress and anxiety and can improve endothelial function, heart rate variability and systemic inflammation. All of these factors that play a major role in the initiation and maintenance of AF can be positively modulated by yoga, resulting in the decreasing incidence of AF episodes, he said.

“Yoga would be a good complement to the current AF patients’ therapeutic strategies,” Lakkireddy said. “With yoga, we are able to reduce the number of hospitalizations, increase quality of life and provide comprehensive care to patients with AF.”

Yoga is not the only stress-relief activity that may have a positive effect on AF. Other research has shown that meditation, hypnotherapy, tai chi and qigong may also reduce stress and relieve patients of symptoms of AF. – by Casey Murphy

For more information:

• Lakkireddy D. Role of yoga and stress reduction techniques in the management of AF. Presented at: The 17th Annual International Boston AF Symposium; Jan. 12-14, 2012; Boston.

Disclosure: Dr. Lakkireddy reports no relevant financial disclosures.

Jim Daubert

Yoga or similar activities that lead to better moods or relaxation and different physiologic states probably affect arrhythmias like AF. But, we need more studies that answer questions such as: Were the patients only making recordings when they were symptomatic; would yoga work well in both men and women; and would the effects last longer than the 3 months in this study?

– Jim Daubert, MD
Department of Medicine
Duke University

Disclosure: Dr. Daubert reports no relevant financial disclosures.

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