Yoga vs Regular Exercise for Atrial Fibrillation: Design of the Yoga-AF Randomized Controlled Trial.

Rose Crowley; Sonia Azzopardi; Annie Curtin; Georgia Rendell; Louise Segan; Jeremy William; Kenneth Cho; Nicholas D'Elia; Margareta Sutija; Tommy Kende; David Chieng; Hariharan Sugumar; Aleksandr Voskoboinik; Sandeep Prabhu; Liang-Han Ling; Vaughan G Macefield; Jonathan M Kalman; Peter M Kistler
Abstract
Lifestyle modification is a key pillar of AF management. Yoga has beneficial effects on cardiovascular health and has shown promise as an intervention in AF. However, randomised data are absent. To determine the effect of regular yoga on AF episodes and AF burden in people with paroxysmal or persistent AF over a 12-month period. This is a randomised control trial of a yoga program in addition to standard care, compared to standard care alone in people with paroxysmal or persistent AF undergoing a rhythm control management strategy. 222 participants will be randomised 1:1 to the yoga intervention or control. Yoga will be conducted in studio and online with a target of at least 3 classes/week. Controls will be instructed to exercise for at least 150 minutes/week. Rhythm monitoring will be with implantable loop recorder, or ECG capable smartwatch with AF detection and twice daily ECGs. Autonomic metrics will be assessed in the laboratory by HRV, blood pressure variability and direct recordings of muscle sympathetic nerve activity. Following a 3-month training period, the dual primary endpoints of AF recurrence (time to recurrence, as defined by any sustained atrial tachyarrhythmia lasting > 1 hour) and AF burden will be determined at 12 months. This study aims to determine the impact of yoga on AF recurrence and burden in people with paroxysmal and persistent AF. Yoga may provide an effective non-invasive, non-pharmacologic lifestyle strategy in the management of AF. The trial was pre-registered with the Australian New Zealand Clinical Trials Registry (ACTRN12624000264583).
Journal AMERICAN HEART JOURNAL
ISSN 1097-6744
Published 22 Sep 2025
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Pages
DOI 10.1016/j.ahj.2025.09.010
Type Journal Article
Sponsorship