Key result
Guided yoga therapy was superior to conventional therapy in reducing syncope burden at 12 months (1.1 vs 3.8 episodes, P<0.001) and improving quality of life.
Why the study?
Vasovagal syncope impairs quality of life, and while yoga influences cardiovascular autonomics, its effectiveness in preventing recurrences and improving quality of life required assessment.
Does yoga therapy reduce vasovagal syncope recurrences and improve quality of life in patients with recurrent reflex vasovagal syncope?
RCT (n=97)
randomized
Does yoga therapy reduce vasovagal syncope recurrences and improve quality of life in patients with recurrent reflex vasovagal syncope?
Absolute Event Rate: 1.1% vs 3.8%
p-value: p=<0.001
Guided yoga therapy significantly reduces syncope burden and improves quality of life compared to conventional guideline-directed therapy in patients with recurrent vasovagal syncope.
Supports yoga to reduce syncope burden in recurrent VVS; extends nonpharmacologic options beyond guideline-directed therapy.
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.
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Shenthar et al. (2021) conducted an RCT in recurrent reflex vasovagal syncope (n=97). Yoga therapy vs. Guideline-directed therapy was evaluated on VVS recurrences and QoL (p=<0.001). Guided yoga therapy was superior to conventional therapy in reducing syncope burden at 12 months (1.1 vs 3.8 episodes, P<0.001) and improving quality of life.
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