The Effect of MediYoga on Quality of Life, Blood Pressure and Heart Rate Among Patients With Atrial Fibrillation: A Randomized Controlled Trial

Atrial fibrillation (AF) is the most common cardiac arrythmia, affecting approximately 3% of the adult population. AF is associated with substantial morbidity including increased risk of stroke and heart failure, and increased mortality risk. The risk of developing AF raises with age hence the prevalence of AF is expected to increase substantially in the future, due to increased average life expectancy. The costs from diagnostics, treatments, and in- and out-patient care, is likewise estimated to increase, because of the expanding proportion of old-er individuals, development of treatment options, and intensifying search for undiagnosed AF. Risk factors such as hypertension, coronary artery disease, obesity, type 2 diabetes, stress, alcohol overconsumption, smoking, and sleep apnea are also increasing in prevalence and are potent contributors to the development and progression of AF.

Various symptoms can occur during an AF episode, including dizziness, heart palpitations, chest pain, and fatigue. Standard treatment of AF include rhythm- and/or rate-control medications, electrical cardioversion, and in some cases catheter ablation. The treatment focuses on re-ducing symptoms and improving quality of life (QoL).

AF episodes can have negative impact on patient's physical and mental health, as well as so-cial life. Individuals with AF often report poorer QoL, and experience symptoms of stress, depression, and anxiety. Guidelines recommend self-care programs that reduce symptoms and enhance QoL and recommends regularly physical activity to improve overall cardiovascular health. Yoga has been shown to improve health-related quality of life (HRQoL), reduce blood pressure and heart rate, and reduce AF episodes in small studies in-cluding individuals with paroxysmal AF. MediYoga originates from Kundalini Yoga, and is based on deep breathing, combined with slow movements, meditation, and relaxation exercises. MediYoga is designed so that many of the exercises can be performed while seated.

The increasing proportion of older individuals living with AF, demands new ways of organizing and implement rehabilitation for patients. Tele-health, defined as the delivery of health-related services through digital communication technologies is eligible to provide yoga classes at home. Online interventions might increase the likelihood that participants complete the program, as it can be done in their own surroundings without required transportation. Remote recruitment has increasing potential, as it enhances the possibility to include participants from rural districts, who might not participate in onsite rehabilitation, due to the long distance to a rehabilitation center.

To our knowledge, this study is the first study to investigate the effect of an online yoga intervention for patients with symptomatic paroxysmal AF, using a complete online recruitment and implementation strategy.