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The LIVE-Yoga study included 55 patients with recurrent vasovagal syncope (avg. 39 years; 65.4% women). All patients had at least two syncope or presyncope events 3 months before enrollment. Patients were randomly assigned to a specialized yoga training program plus current guideline-based therapy or current guideline-based therapy alone.
Guideline-based therapy included physical counter-pressure maneuvers, avoidance of known syncope triggers, augmentation of salt and water intake, and drug therapy or pacing were initiated as determined by the treating physician. Patients in the yoga program underwent yoga training at the Center for Integrative Medicine and Research, with eight supervised sessions within two weeks. After that, patients transitioned to home yoga practice for at least five sessions in a week. Patients attended two supervised follow-up sessions after a month, followed by one guided session per month for six months.
“The specially designed yoga module for this trial included postures, breathing, and relaxation techniques that were chosen keeping in view the pathophysiology of vasovagal
syncope. Patients in both groups were similarly followed-up through regular telephone and video calls. Guided practice ensured safety and no adverse events were reported for the duration of the study,” the researchers wrote.
The researchers then paid close attention to the number of syncope and presyncope episodes for 12 months afterwards. Researchers observed fewer syncopal or presyncope
events at 12 months in the yoga training group compared with 2.5 times as many events in the therapy alone group.
Thirteen (43%) patients in the yoga training group remained free of syncope or presyncope events at 12 months compared with four (16%) patients in the therapy alone group.
At 12 months, all Syncope Functional Status Questionnaire scores and two domains of the WHO Quality of Life Brief Field Questionnaire scores were significantly improved.
“We postulate that positive effects of yoga in this study could be related to a multidimensional effect of this intervention acting through both central and peripheral mechanisms, including physical, psychological, and autonomic pathways,” the researchers wrote.
The researchers noted several limitations of the study, including its open-label design, lack of a sham yoga group, and a lower sample size than calculated due to recruiting during the COVID-19 pandemic.
“We believe these findings may make yoga a suitable adjunctive treatment modality for vasovagal syncope,” Sharma and colleagues wrote.