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Effect of Yoga on Quality of Life in Patients With Vasovagal Syncope
Quick Takes
- In a randomized study of yoga as adjunctive treatment for patients with recurrent vasovagal syncope, there was a significant reduction in the mean number of syncopal or presyncopal events at 12 months.
- Yoga may be a safe, efficacious, and inexpensive adjunctive treatment option for patients with vasovagal syncope if these results can be replicated in future studies.
Study Questions:
What is the impact of yoga as an adjunct to standard therapy versus standard therapy alone on the symptomatic burden in patients with recurrent vasovagal syncope (VVS)?
Methods:
Patients with recurrent VVS were randomized to receive either a specialized yoga training program in addition to current guideline-based therapy or current guideline-based therapy alone. The primary outcome was the number of episodes of syncope and presyncope at 12 months. Secondary outcomes included quality of life (QoL) assessment and a functional status questionnaire at 12 months.
Results:
A total of 55 patients underwent randomization. The mean number of syncopal or presyncopal events at 12 months was 0.7 in the intervention arm compared to 2.52 in the control arm (p < 0.01). In the intervention arm, 13 (43%) patients remained free of events versus 4 (16%) patients in the control arm (p = 0.02). At 12 months, there was a significant improvement in the functional status and QoL measures.
Conclusions:
The authors concluded that yoga as adjunctive therapy is superior to standard therapy alone in reducing the symptomatic burden and improving QoL in patients with recurrent VVS.
Perspective:
Recurrent VVS is associated with a significant reduction in the QoL and results in a significant burden on the health care system. Despite its prevalence, there remain very few clinical trial proven interventions to reduce the frequency of spells and the patient’s QoL: avoidance of known triggers, increased consumption of salt and water, and physical counterpressure maneuvers. Some studies have shown limited benefits with drug therapy or pacing in certain populations, but this has not been consistently observed. Yoga practice is thought to exert its benefits through changes in the patient’s physical, psychological, and autonomic state. The results of this study will have to be replicated in future studies before they can be routinely recommended to patients. If it is confirmed in future studies to be of benefit, yoga may become an effective and inexpensive adjunctive treatment for patients with recurrent VVS.
Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Exercise
Keywords: Arrhythmias, Cardiac, Delivery of Health Care, Exercise, Functional Status, Integrative Medicine, Quality of Life, Recurrence, Secondary Prevention, Syncope, Vasovagal, Treatment Outcome, Yoga
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