Perceptions and experiences of MediYoga among patients with paroxysmal atrial fibrillation—An interview study

Highlights

• This is first study describing perceptions and experiences of MediYoga among patients with paroxysmal atrial fibrillation.

• There were none whom had bad experiences of MediYoga and no injuries where expressed.

• Experiences from patients were that MediYoga was easy to use and could be performed in different environments.

• The perceptions were that MediYoga relief symptoms from heart in patients with paroxysmal atrial fibrillation.

• MediYoga seems to be accessible as a tool to manage emotions, as anxiety and worry, which is associated with epsiodes of atrial fibrillation.

Abstract

Objectives

We investigated the perceptions and experiences of a therapeutic yoga form, MediYoga, which is evolved from Kundaliniyoga among patients with symptomatic paroxysmal atrial fibrillation (PAF).

Design and setting

an inductive exploratory design was chosen with individual semi-structured interviews. The study was conducted with 12 participants (7 men and 5 women, average age 63.5) at a university hospital, Sweden. Informed consent was obtained from all participants. The data were analyzed using a qualitative content analysis with an inductive method and a manifest approach.

Results

Three categories were found in the analysis. In the category “A time for a sense of existence and presence”, the patients described an increased thoughtfulness and experiences of gaining access to an inner self. The category “A way of gaining well-being and increased consciousness” describes patients` feelings of relaxation and feeling of comfort, with components of mental and physical well-being. Furthermore, “Access to a tool to gain willpower and relieve symptoms” describes the perceptions from patients to obtained access to a tool for handling the emotions, such as fear and anxiety, as well as symptoms that they could struggling with between, and during, their episodes of atrial fibrillation. No adverse events were reported by the yoga group, during the study.

Conclusions

Patients with PAF described MediYoga as an accessible tool to manage emotions and symptoms related to episodes of AF. MediYoga may also assist in enhancing body awareness, whereby physical, mental and spiritual components are integrated. MediYoga may strengthen self-management among patients with PAF.

Introduction

Atrial fibrillation (AF) is the most common heart rhythm disturbance associated with high mortality, morbidity and hospitalization.¹ Episodes of atrial fibrillation (i.e. paroxysmal atrial fibrillation, PAF) are correlated with palpitations, dyspnea and fatigue and can cause symptoms such as anxiety, stress and worry.² Reducing symptoms and preventing severe complications, for example stroke, are the primary treatment goals for patients with PAF.¹ The standard treatment is regulation with medication (rhythm-and/or frequency regulation), cardio version and/or ablation.¹ Patients with PAF reported that stress was one of the most perceived causes in episodes of AF,³ and a recent study showed that AF had a substantial impact on patients’ lives.⁴

Compared to the general population and patients with other cardiovascular diseases, patients with PAF experience a deteriorated health-related quality of life (HRQoL), which can influence their social situation and working habits.^3,5,6 A high arrhythmia burden and heart rate can also cause a decreased HRQoL.⁷ The literature shows that it is important to teach self-management to patients with PAF ⁸ and there is also a need for practical tools to handle their emotions, such as anxiety and worry, that can occur with AF.⁹ Physical exercise, such as a self-care program, increased QoL in patients with PAF after an ablation. However, the results showed that changes did not appear to concern mental well-being.¹⁰

Yoga, as a complementary and alternative method, has also been suggested as a technique to manage symptoms occurring in episodes of AF to strengthen self-management.¹¹ Yoga was introduced to the West at the beginning of the 19th century, and has now been explored as an effective form of exercise in the community.¹² However, yoga also includes aspects such as mental training (meditation) and various breathing techniques,¹³ which can contribute to calming biological functions and relieving stress.¹² In relation to other diseases, yoga has been shown to increase HRQoL in patients with hypertension and heart failure.^14,15 Moreover, yoga has also been seen to have positive effects as a self-care program in cancer-care and treatment for low-back pain.^16,17 Furthermore, HRQoL increased when patients with PAF performed yoga as well as feelings of depression and anxiety decreased.¹⁸ In another study, patients with stress-related symptoms reported that, in MediYoga, a therapeutic yoga form, (www.mediyogainstitutet.se) ¹⁹ they had received a tool with which to manage their stress.²⁰

There is substantial evidence of impaired HRQoL in patients with PAF. HRQoL in this context is connected to subjective symptoms and emotions during episodes of AF. However, to our knowledge, few studies have evaluated self-management programs aiming to decrease symptoms, as well as improve well-being and HRQoL in patients with PAF. In caring science, the goal and overall objective are to support and strengthen peoples´ health processes.²¹ In relation to this and existential needs, treatments for patients with AF are at odds with individual human personal desires. Therefore, it is important to provide support and assistance to this population in their health process and strengthen their self-management.

There is a lack of knowledge about complementary methods, such as yoga, for patients with PAF. Therefore, it is important to describe the experiences and perceptions of performing MediYoga.

The aim was to describe perceptions and experiences of MediYoga among patients with symptomatic PAF.