Skip to main content
Erschienen in: Journal of Interventional Cardiac Electrophysiology 2/2015

01.08.2015

Role of yoga as an adjunctive therapy in patients with neurocardiogenic syncope: a pilot study

verfasst von: Sampath Gunda, Arun Kanmanthareddy, Donita Atkins, Sudharani Bommana, Rhea Pimentel, Jeanne Drisko, Luigi Dibiase, Salwa Beheiry, Steven Hao, Andrea Natale, Dhanunjaya Lakkireddy

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Neurocardiogenic syncope (NCS) is a common clinical condition characterized by abrupt cardiovascular autonomic changes resulting in syncope. This is a recurring condition with mixed results from current strategies of treatment.

Methods

Subjects with a diagnosis of NCS were screened and enrolled. All the participants were given a DVD containing yoga videos and were instructed to practice yoga therapy for 60 min, three times a week for 3 consecutive months. Syncope functional status questionnaire score (SFSQS) was administered at the beginning and the end of the study. The subjects were followed for 3 months and underwent repeat tilt table testing at the end of the study.

Results

Of the 60 patients screened, 44 subjects were enrolled, 21 in the intervention group and 23 in the control group. Most of the participants were females, and the mean age was 21 ± 3 years. In the intervention group, who finished the yoga regimen, there was a statistically significant improvement from control phase to the intervention phase, in number of episodes of syncope (4 ± 1 vs 1.3 ± 0.7, p < 0.001) and presyncope (4.7 ± 1.5 vs 1.5 ± 0.5, p < 0.001). The mean SFSQS also decreased from 67 ± 7.8 to 29.8 ± 4.6 (p < 0.001). All subjects had positive head up tilt table (HUTT) study at the time of enrollment compared to only six patients at the completion of intervention phase (10/100 vs 6/28 %, p < 0.0001).

Conclusion

Yoga therapy can potentially improve the symptoms of presyncope and syncope in young female patients with NCS.
Literatur
1.
Zurück zum Zitat Freeman, R., et al. (2011). Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical Autonomic Research, 21(2), 69–72.PubMedCrossRef Freeman, R., et al. (2011). Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical Autonomic Research, 21(2), 69–72.PubMedCrossRef
2.
3.
Zurück zum Zitat Sun, B. C. (2013). Quality-of-life, health service use, and costs associated with syncope. Progress in Cardiovascular Diseases, 55(4), 370–5.PubMedCrossRef Sun, B. C. (2013). Quality-of-life, health service use, and costs associated with syncope. Progress in Cardiovascular Diseases, 55(4), 370–5.PubMedCrossRef
4.
Zurück zum Zitat Raj, S. R., & Coffin, S. T. (2013). Medical therapy and physical maneuvers in the treatment of the vasovagal syncope and orthostatic hypotension. Progress in Cardiovascular Diseases, 55(4), 425–33.PubMedCentralPubMedCrossRef Raj, S. R., & Coffin, S. T. (2013). Medical therapy and physical maneuvers in the treatment of the vasovagal syncope and orthostatic hypotension. Progress in Cardiovascular Diseases, 55(4), 425–33.PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Bartoletti, A., et al. (2008). Physical injuries caused by a transient loss of consciousness: main clinical characteristics of patients and diagnostic contribution of carotid sinus massage. European Heart Journal, 29(5), 618–24.PubMedCrossRef Bartoletti, A., et al. (2008). Physical injuries caused by a transient loss of consciousness: main clinical characteristics of patients and diagnostic contribution of carotid sinus massage. European Heart Journal, 29(5), 618–24.PubMedCrossRef
6.
Zurück zum Zitat Iyengar, B. K. S. (2007). BKS Iyengar yoga: The path to holistic health (Rev. ed.): DK publishing, New York NY. Iyengar, B. K. S. (2007). BKS Iyengar yoga: The path to holistic health (Rev. ed.): DK publishing, New York NY.
7.
Zurück zum Zitat Feuerstein, G. (1998). The yoga tradition: its history, literature, philosophy, and practice. AZ: Hohm Press Prescott. Feuerstein, G. (1998). The yoga tradition: its history, literature, philosophy, and practice. AZ: Hohm Press Prescott.
8.
Zurück zum Zitat Cramer, H., et al. (2015). A systematic review of yoga for heart disease. European Journal Preventive Cardiology, 22(3), 284-95. Cramer, H., et al. (2015). A systematic review of yoga for heart disease. European Journal Preventive Cardiology, 22(3), 284-95.
9.
Zurück zum Zitat Pullen, P. R., et al. (2008). Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure. Journal of Cardiac Failure, 14(5), 407–13.PubMedCrossRef Pullen, P. R., et al. (2008). Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure. Journal of Cardiac Failure, 14(5), 407–13.PubMedCrossRef
10.
Zurück zum Zitat Lakkireddy, D., et al. (2013). Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: the YOGA My Heart Study. Journal of the American College of Cardiology, 61(11), 1177–82.PubMedCrossRef Lakkireddy, D., et al. (2013). Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: the YOGA My Heart Study. Journal of the American College of Cardiology, 61(11), 1177–82.PubMedCrossRef
11.
Zurück zum Zitat Wolff, M., et al. (2013). Impact of yoga on blood pressure and quality of life in patients with hypertension - a controlled trial in primary care, matched for systolic blood pressure. BMC Cardiovascular Disorders, 13, 111.PubMedCentralPubMedCrossRef Wolff, M., et al. (2013). Impact of yoga on blood pressure and quality of life in patients with hypertension - a controlled trial in primary care, matched for systolic blood pressure. BMC Cardiovascular Disorders, 13, 111.PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Epstein, A. E., et al. (2013). 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 61(3), e6–75.PubMedCrossRef Epstein, A. E., et al. (2013). 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 61(3), e6–75.PubMedCrossRef
13.
Zurück zum Zitat Ganzeboom, K. S., et al. (2003). Prevalence and triggers of syncope in medical students. The American Journal of Cardiology, 91(8), 1006–8. A8.PubMedCrossRef Ganzeboom, K. S., et al. (2003). Prevalence and triggers of syncope in medical students. The American Journal of Cardiology, 91(8), 1006–8. A8.PubMedCrossRef
14.
Zurück zum Zitat Scott, W. A., et al. (1995). Randomized comparison of atenolol and fludrocortisone acetate in the treatment of pediatric neurally mediated syncope. The American Journal of Cardiology, 76(5), 400–2.PubMedCrossRef Scott, W. A., et al. (1995). Randomized comparison of atenolol and fludrocortisone acetate in the treatment of pediatric neurally mediated syncope. The American Journal of Cardiology, 76(5), 400–2.PubMedCrossRef
15.
Zurück zum Zitat Salim, M. A., & Di Sessa, T. G. (2005). Effectiveness of fludrocortisone and salt in preventing syncope recurrence in children: a double-blind, placebo-controlled, randomized trial. Journal of the American College of Cardiology, 45(4), 484–8.PubMedCrossRef Salim, M. A., & Di Sessa, T. G. (2005). Effectiveness of fludrocortisone and salt in preventing syncope recurrence in children: a double-blind, placebo-controlled, randomized trial. Journal of the American College of Cardiology, 45(4), 484–8.PubMedCrossRef
16.
Zurück zum Zitat Raj, S. R., et al. (2006). The Second Prevention of Syncope Trial (POST II)--a randomized clinical trial of fludrocortisone for the prevention of neurally mediated syncope: rationale and study design. American Heart Journal, 151(6), 1186.e11-7.PubMedCrossRef Raj, S. R., et al. (2006). The Second Prevention of Syncope Trial (POST II)--a randomized clinical trial of fludrocortisone for the prevention of neurally mediated syncope: rationale and study design. American Heart Journal, 151(6), 1186.e11-7.PubMedCrossRef
17.
Zurück zum Zitat Perez-Lugones, A., et al. (2001). Usefulness of midodrine in patients with severely symptomatic neurocardiogenic syncope: a randomized control study. Journal of Cardiovascular Electrophysiology, 12(8), 935–8.PubMedCrossRef Perez-Lugones, A., et al. (2001). Usefulness of midodrine in patients with severely symptomatic neurocardiogenic syncope: a randomized control study. Journal of Cardiovascular Electrophysiology, 12(8), 935–8.PubMedCrossRef
19.
Zurück zum Zitat Kaufmann, H., Saadia, D., & Voustianiouk, A. (2002). Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study. Annals of Neurology, 52(3), 342–5.PubMedCrossRef Kaufmann, H., Saadia, D., & Voustianiouk, A. (2002). Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study. Annals of Neurology, 52(3), 342–5.PubMedCrossRef
20.
Zurück zum Zitat Qingyou, Z., Junbao, D., & Chaoshu, T. (2006). The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope. The Journal of Pediatrics, 149(6), 777–80.PubMedCrossRef Qingyou, Z., Junbao, D., & Chaoshu, T. (2006). The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope. The Journal of Pediatrics, 149(6), 777–80.PubMedCrossRef
21.
Zurück zum Zitat Romme, J. J., et al. (2011). Effectiveness of midodrine treatment in patients with recurrent vasovagal syncope not responding to non-pharmacological treatment (STAND-trial). Europace, 13(11), 1639–47.PubMedCrossRef Romme, J. J., et al. (2011). Effectiveness of midodrine treatment in patients with recurrent vasovagal syncope not responding to non-pharmacological treatment (STAND-trial). Europace, 13(11), 1639–47.PubMedCrossRef
22.
Zurück zum Zitat Sud, S., et al. (2007). The expectation effect and cardiac pacing for refractory vasovagal syncope. The American Journal of Medicine, 120(1), 54–62.PubMedCrossRef Sud, S., et al. (2007). The expectation effect and cardiac pacing for refractory vasovagal syncope. The American Journal of Medicine, 120(1), 54–62.PubMedCrossRef
23.
Zurück zum Zitat Brignole, M., et al. (2012). Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial. Circulation, 125(21), 2566–71.PubMedCrossRef Brignole, M., et al. (2012). Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial. Circulation, 125(21), 2566–71.PubMedCrossRef
24.
Zurück zum Zitat Madhavan, M., et al. (2013). Renal nerve stimulation for the treatment of neurocardiogenic syncope. Cardiovascular Revascularization Medicine, 14(3), 172–3.PubMedCrossRef Madhavan, M., et al. (2013). Renal nerve stimulation for the treatment of neurocardiogenic syncope. Cardiovascular Revascularization Medicine, 14(3), 172–3.PubMedCrossRef
25.
Zurück zum Zitat Mosqueda-Garcia, R., et al. (2000). The elusive pathophysiology of neurally mediated syncope. Circulation, 102(23), 2898–906.PubMedCrossRef Mosqueda-Garcia, R., et al. (2000). The elusive pathophysiology of neurally mediated syncope. Circulation, 102(23), 2898–906.PubMedCrossRef
26.
Zurück zum Zitat Secher, N. H., Perko, G., & Olesen, H. L. (1992). Effect of exercise on vasovagal (pre-)syncope. Scandinavian Journal of Medicine & Science in Sports, 2(3), 160–161.CrossRef Secher, N. H., Perko, G., & Olesen, H. L. (1992). Effect of exercise on vasovagal (pre-)syncope. Scandinavian Journal of Medicine & Science in Sports, 2(3), 160–161.CrossRef
27.
Zurück zum Zitat Smith, M. L., Hudson, D. L., & Raven, P. B. (1987). Effect of muscle tension on the cardiovascular responses to lower body negative pressure in man. Medicine and Science in Sports and Exercise, 19(5), 436–42.PubMedCrossRef Smith, M. L., Hudson, D. L., & Raven, P. B. (1987). Effect of muscle tension on the cardiovascular responses to lower body negative pressure in man. Medicine and Science in Sports and Exercise, 19(5), 436–42.PubMedCrossRef
28.
Zurück zum Zitat Wieling, W., van Lieshout, J. J., & van Leeuwen, A. M. (1993). Physical manoeuvres that reduce postural hypotension in autonomic failure. Clinical Autonomic Research, 3(1), 57–65.PubMedCrossRef Wieling, W., van Lieshout, J. J., & van Leeuwen, A. M. (1993). Physical manoeuvres that reduce postural hypotension in autonomic failure. Clinical Autonomic Research, 3(1), 57–65.PubMedCrossRef
29.
Zurück zum Zitat Rowell, L. B., & O'Leary, D. S. (1990). Reflex control of the circulation during exercise: chemoreflexes and mechanoreflexes. Journal of Applied Physiology (1985), 69(2), 407–18. Rowell, L. B., & O'Leary, D. S. (1990). Reflex control of the circulation during exercise: chemoreflexes and mechanoreflexes. Journal of Applied Physiology (1985), 69(2), 407–18.
30.
Zurück zum Zitat Innes, K. E., Bourguignon, C., & Taylor, A. G. (2005). Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. The Journal of the American Board of Family Practice, 18(6), 491–519.PubMedCrossRef Innes, K. E., Bourguignon, C., & Taylor, A. G. (2005). Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. The Journal of the American Board of Family Practice, 18(6), 491–519.PubMedCrossRef
31.
Zurück zum Zitat Khanam, A. A., et al. (1996). Study of pulmonary and autonomic functions of asthma patients after yoga training. Indian Journal of Physiology and Pharmacology, 40(4), 318–24.PubMed Khanam, A. A., et al. (1996). Study of pulmonary and autonomic functions of asthma patients after yoga training. Indian Journal of Physiology and Pharmacology, 40(4), 318–24.PubMed
32.
Zurück zum Zitat Cohen, D. L., et al. (2009). Cerebral blood flow effects of yoga training: preliminary evaluation of 4 cases. Journal of Alternative and Complementary Medicine, 15(1), 9–14.PubMedCentralCrossRef Cohen, D. L., et al. (2009). Cerebral blood flow effects of yoga training: preliminary evaluation of 4 cases. Journal of Alternative and Complementary Medicine, 15(1), 9–14.PubMedCentralCrossRef
33.
Zurück zum Zitat Khattab, K., et al. (2007). Iyengar yoga increases cardiac parasympathetic nervous modulation among healthy yoga practitioners. Evidence-based Complementary and Alternative Medicine, 4(4), 511–7.PubMedCentralPubMedCrossRef Khattab, K., et al. (2007). Iyengar yoga increases cardiac parasympathetic nervous modulation among healthy yoga practitioners. Evidence-based Complementary and Alternative Medicine, 4(4), 511–7.PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Vyas, R., & Dikshit, N. (2002). Effect of meditation on respiratory system, cardiovascular system and lipid profile. Indian Journal of Physiology and Pharmacology, 46(4), 487–91.PubMed Vyas, R., & Dikshit, N. (2002). Effect of meditation on respiratory system, cardiovascular system and lipid profile. Indian Journal of Physiology and Pharmacology, 46(4), 487–91.PubMed
35.
Zurück zum Zitat Bera, T. K., Gore, M. M., & Oak, J. P. (1998). Recovery from stress in two different postures and in Shavasana–a yogic relaxation posture. Indian Journal of Physiology and Pharmacology, 42(4), 473–8.PubMed Bera, T. K., Gore, M. M., & Oak, J. P. (1998). Recovery from stress in two different postures and in Shavasana–a yogic relaxation posture. Indian Journal of Physiology and Pharmacology, 42(4), 473–8.PubMed
36.
Zurück zum Zitat Muralidhara, D. V., & Ranganathan, K. V. (1982). Effect of yoga practice on cardiac recovery index. Indian Journal of Physiology and Pharmacology, 26(4), 279–83.PubMed Muralidhara, D. V., & Ranganathan, K. V. (1982). Effect of yoga practice on cardiac recovery index. Indian Journal of Physiology and Pharmacology, 26(4), 279–83.PubMed
37.
Zurück zum Zitat Danilowicz-Szymanowicz, L., et al. (2013). Effect of various forms of physical training on the autonomic nervous system activity in patients with acute myocardial infarction. Kardiologia Polska, 71(6), 558–65.PubMedCrossRef Danilowicz-Szymanowicz, L., et al. (2013). Effect of various forms of physical training on the autonomic nervous system activity in patients with acute myocardial infarction. Kardiologia Polska, 71(6), 558–65.PubMedCrossRef
Metadaten
Titel
Role of yoga as an adjunctive therapy in patients with neurocardiogenic syncope: a pilot study
verfasst von
Sampath Gunda
Arun Kanmanthareddy
Donita Atkins
Sudharani Bommana
Rhea Pimentel
Jeanne Drisko
Luigi Dibiase
Salwa Beheiry
Steven Hao
Andrea Natale
Dhanunjaya Lakkireddy
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2015
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-015-9996-1

Weitere Artikel der Ausgabe 2/2015

Journal of Interventional Cardiac Electrophysiology 2/2015 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.