Background: Vasovagal syncope (VVS) is often recurrent and is associated with decreased quality of life (QoL).
Objective: To assess the effectiveness of yoga therapy on recurrence of VVS and QoL.
Methods: We randomized subjects with recurrent syncope (>3 episodes) suggestive of VVS and positive head-up tilt test to guideline-directed therapy (Group 1) or yoga therapy (Group 2). Patients in Group 1 were counseled about dietary modification and taught physical counterpressure maneuvers. Group 2 patients were only taught yoga [pranayama (breathing techniques), asanas (postures) and dhyana (meditation)] by a certified instructor and advised to perform yoga for 60 minutes at least five days/week. Both groups were followed monthly in the syncope clinic, recording VVS recurrences and QoL using the syncope functional status questionnaire score.
Results: We prospectively enrolled and randomized 97 symptomatic syncope patients (Group 1: 47 and Group 2: 50) between June 2015 to February 2017. Mean age was 33.1±16.6 years, with a male: female ratio of 1:1.1, symptom duration of 17.1±20.7 months, with a mean of 6.4±6.1 syncope episodes. Over a follow up of 8.3+2.1 months, there were fewer syncope recurrences in Group 2 compared to Group 1 at three [0.8±0.9 vs. 1.8±1.4 (P<0.001)] months and at six months [0.98±1.23 vs. 3.38±3.0 (P<0.001)], with a significantly better QoL (<0.001) in Group 2 compared to Group 1.
Conclusion: For patients with recurrent VVS, guided yoga therapy is superior to conventional dietary and physical counter-pressure therapy for recurrence prevention, and maybe a useful treatment strategy.