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eCAM Advance Access published online on October 27, 2007
eCAM, doi:10.1093/ecam/nem087
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© 2007 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Iyengar Yoga Increases Cardiac Parasympathetic Nervous Modulation Among Healthy Yoga Practitioners

Kerstin Khattab1, Ahmed A. Khattab1, Jasmin Ortak2, Gert Richardt1 and Hendrik Bonnemeier2

1Herz-Kreislauf-Zentrum Segeberger Kliniken GmbH, Bad Segeberg and 2Medizinische Klinik II, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lübeck, Germany

Relaxation techniques are established in managing of cardiac patients during rehabilitation aiming to reduce future adverse cardiac events. It has been hypothesized that relaxation-training programs may significantly improve cardiac autonomic nervous tone. However, this has not been proven for all available relaxation techniques. We tested this assumption by investigating cardiac vagal modulation during yoga.We examined 11 healthy yoga practitioners (7 women and 4 men, mean age: 43 ± 11; range: 26–58 years). Each individual was subjected to training units of 90 min once a week over five successive weeks. During two sessions, they practiced a yoga program developed for cardiac patients by B.K.S. Iyengar. On three sessions, they practiced a placebo program of relaxation. On each training day they underwent ambulatory 24 h Holter monitoring. The group of yoga practitioners was compared to a matched group of healthy individuals not practicing any relaxation techniques. Parameters of heart rate variability (HRV) were determined hourly by a blinded observer. Mean RR interval (interval between two R-waves of the ECG) was significantly higher during the time of yoga intervention compared to placebo and to control (P < 0.001 for both). The increase in HRV parameters was significantly higher during yoga exercise than during placebo and control especially for the parameters associated with vagal tone, i.e. mean standard deviation of NN (Normal Beat to Normal Beat of the ECG) intervals for all 5-min intervals (SDNNi, P < 0.001 for both) and root mean square successive difference (rMSSD, P < 0.01 for both). In conclusion, relaxation by yoga training is associated with a significant increase of cardiac vagal modulation. Since this method is easy to apply with no side effects, it could be a suitable intervention in cardiac rehabilitation programs.

Keywords: yoga – Iyengar Yoga – heart-rate-variability – cardiac rehabilitation

For reprints and all correspondence: Kerstin Khattab, MD, Segeberger Kliniken GmbH, Am Kurpark 1, 23795 Bad Segeberg, Germany. E-mail: kerstinkhattab{at}t-online.de

Received October 22, 2006; accepted April 23, 2007


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