A randomized study of yoga therapy for the prevention of recurrent reflex vasovagal syncope

Aims Vasovagal syncope (VVS) is a common cardiovascular dysautonomic disorder that significantly impacts health and quality of life (QoL). Yoga has been shown to have a positive influence on cardiovascular autonomics. This study assessed the effectiveness of yoga therapy on the recurrence of VVS and QoL. Methods and results We randomized subjects with recurrent reflex VVS (>3 episodes in the past 1 year) and positive head-up tilt test to guideline-directed therapy (Group 1) or yoga therapy (Group 2). Patients in Group 1 were advised guideline-directed treatment and Group 2 was taught yoga by a certified instructor. The primary endpoint was VVS recurrences and QoL. Between June 2015 and February 2017, 97 highly symptomatic VVS patients were randomized (Group 1: 47 and Group 2: 50). The mean age was 33.1 +/- 16.6 years, male:female of 40:57, symptom duration of 17.1 +/- 20.7 months, with a mean of 6.4 +/- 6.1 syncope episodes. Over a follow-up of 14.3 +/- 2.1 months Group 2 had significantly lower syncope burden compared with Group 1 at 3 (0.8 +/- 0.9 vs. 1.8 +/- 1.4, P< 0.001), 6 (1.0 +/- 1.2 vs. 3.4 +/- 3.0, P< 0.001), and at 12 months (1.1 +/- 0.8 vs. 3.8 +/- 3.2, P< 0.001). The Syncope functional score questionnaire was significantly lower in Group 2 compared with Group 1 at 3 (31.4 +/- 7.2 vs. 64.1 +/- 11.5, P<0.001), 6 (26.4 +/- 6.3 vs. 61.4 +/- 10.7, P< 0.001), and 12 months (22.2 +/- 4.7 vs. 68.3 +/- 11.4, P< 0.001). Conclusion For patients with recurrent VVS, guided yoga therapy is superior to conventional therapy in reducing symptom burden and improving QoL. [GRAPHICS] .