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Yoga: An Old Discipline With a New Indication for Reducing Cardiac Arrhythmias PDF

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View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by CommonKnowledge Pacific University CommonKnowledge School of Physician Assistant Studies Theses, Dissertations and Capstone Projects Summer 8-9-2014 Yoga: An Old Discipline With a New Indication for Reducing Cardiac Arrhythmias Duane (DJ) Fenn Pacific University Follow this and additional works at:http://commons.pacificu.edu/pa Part of theMedicine and Health Sciences Commons Recommended Citation Fenn, Duane (DJ), "Yoga: An Old Discipline With a New Indication for Reducing Cardiac Arrhythmias" (2014).School of Physician Assistant Studies.Paper 473. This Capstone Project is brought to you for free and open access by the Theses, Dissertations and Capstone Projects at CommonKnowledge. It has been accepted for inclusion in School of Physician Assistant Studies by an authorized administrator of CommonKnowledge. For more information, please [email protected]. Yoga: An Old Discipline With a New Indication for Reducing Cardiac Arrhythmias Abstract Background:Cardiac arrhythmias are any abnormality or disruption of the normal activation sequence of the myocardium in the heart. Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with increased mortality and morbidity. Patients with cardiac arrhythmias have a decreased quality of life (QoL) and an increased psychosocial burden. Yoga has demonstrated to be an effective tool in reducing blood pressure in patients with hypertension, reducing symptoms of depression, anxiety, and increasing QoL. Yoga as a treatment for patients with cardiac arrhythmias has yet to be investigated fully. Will yoga decrease the amount of cardiac arrhythmias in arrhythmia-prone individuals? Methods:An exhaustive search of available medical literature was performed using Medline-OVID, CINAHL, PubMed, and Web of Science using the keywords: “yoga”, “arrhythmias, cardiac.” A search of the National Institute of Health (NIH) clinical trials website showed one related clinical trial currently recruiting. Results:Two studies met inclusion criteria and were included in the systematic review. The first study is an observational pre-post cohort study that examined the impact of a structured 3-month yoga program on AF. Fifty two patients were enrolled and results showed dramatic decreases in the frequency of AF while in the yoga program compared to the control period. The second study is a retrospective observational cohort study to determine the effects of Pranayama, a type of yoga breathing exercise, on the QT dispersion (QTd) in patients with arrhythmias. Fifteen patients were enrolled in the analysis and results demonstrate a statistically significant decrease in the QTd as captured on electrocardiogram (ECG) over the course of the 12-week yoga- breathing program. Conclusion:Yoga is a successful complementary and alternative treatment for cardiac arrhythmias. It can help lower blood pressure, stress, anxiety and depression that may trigger episodes of AF or other cardiac arrhythmias. The cost of yoga is much less than medications and has little to no adverse effects. Although clinical trials are needed to give more support to the evidence presented in these studies, Yoga should be implemented in therapy strategies for patients with cardiac arrhythmias. Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor A.J. Sommers Second Advisor Saje Davis-Risen This capstone project is available at CommonKnowledge:http://commons.pacificu.edu/pa/473 Keywords Yoga, Arrhythmias, Cardiac, Atrial fibrillation, Quality of life Subject Categories Medicine and Health Sciences Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge:http://commons.pacificu.edu/pa/473 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license.] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. [email protected] This capstone project is available at CommonKnowledge:http://commons.pacificu.edu/pa/473 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed. Yoga: An Old Diisscciipplliinnee With a New Indication ffoorr RReedduucciinngg Cardiac Arrhythmias Duane J (DJ) Fenn AAA CCCllliiinnniiicccaaalll GGGrrraaaddduuuaaattteee PPPrrrooojjjeeecccttt SSSuuubbbmmmiiitttttteeeddd tttooo ttthhheee FFFaaacccuuullltttyyy ooofff ttthhheee SScchhooooll ooff Physician Assistant Studies Pacific University Hillsboro, OR FFoorr tthhee MMaasstteerrss ooff SScciieennccee DDeeggrreeee,, August 2014 FFaaccuullttyy AAddvviissoorr:: Duc Vo, MD CCCllliiinnniiicccaaalll GGGrrraaaddduuuaaattteee PPPrrrooojjjeeecccttt CCCoooooorrrdddiiinnnaaatttooorrr::: AAAnnnnnnjjjaaannneeetttttteee SSSooommmmmmeeerrrsss,,, PPPAAA-C, MS - 1 - Biography DJ Fenn is a native of Arizona, where he received his Bachelor of Science degree in Health Administration from the University of Phoenix. After completing his degree, he worked as a Clinical Research Coordinator where he abetted in over 15 different clinical trials before entering Pacific University’s PA Program. DJ enjoys all types of music and plays the guitar. He also enjoys tennis, and spending time with his wife and family. - 2 - Abstract Background: Cardiac arrhythmias are any abnormality or disruption of the normal activation sequence of the myocardium in the heart. Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with increased mortality and morbidity. Patients with cardiac arrhythmias have a decreased quality of life (QoL) and an increased psychosocial burden. Yoga has demonstrated to be an effective tool in reducing blood pressure in patients with hypertension, reducing symptoms of depression, anxiety, and increasing QoL. Yoga as a treatment for patients with cardiac arrhythmias has yet to be investigated fully. Will yoga decrease the amount of cardiac arrhythmias in arrhythmia-prone individuals? Methods: An exhaustive search of available medical literature was performed using Medline-OVID, CINAHL, PubMed, and Web of Science using the keywords: “yoga”, “arrhythmias, cardiac.” A search of the National Institute of Health (NIH) clinical trials website showed one related clinical trial currently recruiting. Results: Two studies met inclusion criteria and were included in the systematic review. The first study is an observational pre-post cohort study that examined the impact of a structured 3-month yoga program on AF. Fifty two patients were enrolled and results showed dramatic decreases in the frequency of AF while in the yoga program compared to the control period. The second study is a retrospective observational cohort study to determine the effects of Pranayama, a type of yoga breathing exercise, on the QT dispersion (QTd) in patients with arrhythmias. Fifteen patients were enrolled in the analysis and results demonstrate a statistically significant decrease in the QTd as captured on electrocardiogram (ECG) over the course of the 12-week yoga-breathing program. Conclusion: Yoga is a successful complementary and alternative treatment for cardiac arrhythmias. It can help lower blood pressure, stress, anxiety and depression that may trigger episodes of AF or other cardiac arrhythmias. The cost of yoga is much less than medications and has little to no adverse effects. Although clinical trials are needed to give more support to the evidence presented in these studies, Yoga should be implemented in therapy strategies for patients with cardiac arrhythmias. • • • Keywords: Yoga Arrhythmias, cardiac Atrial fibrillation Quality of life - 3 - Acknowledgements To my Wife: I lack the depth of words needed to express my thanks for all the help and support you have given me during this process. Thank you with all that I have. To The faculty at Pacific University: Thank you for all the inspiration and continuous support that I have received during my PA school experience. - 4 - Table of Contents Biography ................................................................................................................................................... 2 Abstract ....................................................................................................................................................... 3 Acknowledgements ................................................................................................................................ 4 Table of Contents .................................................................................................................................... 5 List of Tables ............................................................................................................................................. 6 List of Figures ........................................................................................................................................... 6 List of Abbreviations.............................................................................................................................. 6 BACKGROUND .......................................................................................................................................... 7 METHODS .................................................................................................................................................. 9 RESULTS ..................................................................................................................................................... 9 DISCUSSION ........................................................................................................................................... 13 CONCLUSION ......................................................................................................................................... 15 References .............................................................................................................................................. 16 Figure 1. Differences in Primary Efficacy Outcomes Measures Between the Control and Intervention Phase.........................................................................................................................19 Table 1. Characteristics of Reviewed Studies ........................................................................... 20 - 5 -

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Yoga as a treatment for patients with cardiac arrhythmias has yet to be investigated fully. to determine the effects of Pranayama, a type of yoga breathing exercise, on the QT .. exercises, breathing techniques, and meditation. Any AF lasting greater than 30 seconds was logged as an episode.
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