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Blood pressure and heart rate declined significantly in patients with atrial fibrillation after 3 months of weekly yoga sessions, results of a small clinical study showed. And Turkish investigators reported similar improvements in patients treated with a short course of acupressure.

In the yoga study, mean systolic blood pressure decreased by 5 mm Hg and diastolic pressure by 6 mm Hg in patients randomized to yoga, whereas blood pressure increased in patients who received usual care. Heart rate slowed by 4 bpm with yoga as compared with an increase of 4 bpm in the control group.

Patients in the yoga arm also reported significant improvement in quality of life, Maria Nilsson, of the Karolinska Institute in Stockholm, reported at EuroHeartCare in Glasgow, Scotland.

"Medical yoga with light movements, deep breathing, and relaxation leads to subjective improvement in health and lower blood pressure and heart rate," Nilsson and colleagues concluded. "These effects may be of importance [and suggest that] medical yoga can be a complementary treatment method for patients with paroxysmal atrial fibrillation."

Patients with atrial fibrillation often report poorer subjective quality of life. Medical application of yoga has been shown to benefit physical and mental well-being. Whether the benefits might extend to atrial fibrillation had not been examined.

To gain data on the issue, Nilsson and colleagues conducted a randomized trial involving 80 patients with paroxysmal atrial fibrillation. All patients continued usual care and were randomized to yoga or no additional intervention. In the yoga arm, patients attended a 1-hour supervised session once a week for 3 months.

Blood pressure and heart rate were assessed at the beginning of the study and after 3 months. Additionally, patients completed two health-related quality of life questionnaires (SF-36 and EQ-5D visual analog scale) before and after the study.

Baseline blood pressure averaged 137/83 mm Hg in the yoga group and 138/84 mm Hg in the control group.

After 3 months, mean systolic blood pressure had decreased to 132 mm Hg in the yoga arm (P=0.03) versus an increase to 141 mm Hg in the control group. Mean diastolic pressure decreased to 77 mm Hg in the yoga group (P=0.007) but increased to 87 mm Hg in the control group.

Mean heart rate decreased from 64 to 60 bpm in patients randomized to yoga (P=0.02) but increased in the control group from 65 bpm at baseline to 69 bpm after 3 months.

Pre- and post-intervention scores on the SF-36 questionnaire showed significant improvement in the physical and mental components of the scale in the yoga group (P=0.01, P=0.02 versus the control group). Investigators also noted improvement in the EQ-5D in the yoga versus control group.

The clinical evaluation of acupressure involved 60 patients with chronic atrial fibrillation. They were randomized to usual care with or without complementary acupressure, applied at three pressure points by means of a device developed for the trial. Patients allocated to acupressure underwent treatment twice daily for two to four sessions.

Outcomes of interest were change in heart rhythm, heart rate, and fatigue. Heart rate and both systolic and diastolic blood pressure decreased significantly in the acupressure group (P<0.05) but not in the control group, reported Ozlem Ceyhan, MD, of Erciyes University in Kayseri, Turkey.

Only diastolic blood pressure decreased after the first acupressure session.

Heart rate decreased in the acupressure group, but no patient reverted to sinus rhythm or had subjective improvement in fatigue.

"Based on this result, repeated acupressure application may be recommended to be used for reducing blood pressure and tempering pulse rate in addition to pharmacological therapy," Ceyhan and colleagues concluded.

From the American Heart Association:

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