Breathing exercise for Atrial Fibrillation

Contrary to popular misconception there is no evidence to suggest that atrial fibrillation is cureable. The most common symptom reported by most patients with atrial fibrillation is symptom fluctuation. The best treatment is therefore symptom control as in any other condition where symptoms are variable in nature.

Atrial fibrillation can present with a wide range of symptoms including a range of abnormal heart rates such as tachycardia, bradycardia, atrial rate and no rhythm. These symptoms are typically found at rest, in the morning or late evenings.

Atrial fibrillation is an abnormal heart rhythm that can occur in people of any age. It arises mostly in the brain and spreads to the rest of the heart via the atrioventricular (AV) node. Atrial fibrillation is common in hospital inpatients but is usually asymptomatic and rarely requires treatment.

Atherosclerosis, especially with plaques as a complication of carotid atherosclerosis, may be the cause of AF. The "clot in the atrium" is likely a result of atrial and left atrial thrombosis from atrial blood-thrombus formation.

The incidence of AF in adults ≥30 years is estimated to be 2.2, i.e., nearly 1 out of every 100 adults in the US had AF.

Various antiarrhythmic medications are used including antiarrhythmic steroids, beta-blocking agents, cardioversion, catheter ablation, and anticoagulation. A multitude of drugs are used in management of AF and it is difficult to recommend a particular therapy in this area.

The studies cited support that breathing exercises are effective in increasing arterial blood pressure and heart rate, improving breathing habits, and decreasing body weight, and therefore, these exercises can be recommended for use in patients who are unable to exercise adequately to strengthen their hearts and counteract the effects of atrial fibrillation.

By combining the two respiratory exercises we observed short- and long-term clinical improvement with exercise training. Results from a recent paper demonstrate that a short period of aerobic training, with a gradual increase of workload, can achieve significant improvements in the health status of patients affected by chronic heart failure.

The risk of stroke is markedly increased by atrial fibrillation in comparison with the general population and is greatest in women of advancing age. In the population studied it is not uncommon to encounter asymptomatic AF. Although the long term risk of stroke is considerable, a number of randomized studies show that anti-fibrillatory drugs are effective in improving long-term survival, that is to say the time before the patient dies to the time of death from either old age or a sudden or heart attack. In spite of this improvement in survival, mortality following atrial fibrillation is still high. This is a reminder that the treatment of atrial fibrillation must be carefully targeted to reduce the risk of stroke.

This is the first study to the effect of breathing exercise in AF patients and the first demonstration of the existence of a physiologic effect on ventricular tachyarrhythmias. Recent findings suggest that breathing exercises may be able to reduce the ventricular tachyarrhythmias and may be helpful in reducing ventricular-universelty. The positive effect on ventricular arrhythmias may be explained by their effect on peripheral vasoconstriction via an acetylcholine-dependent mechanism. Further studies with more homogeneous groups are necessary and can help to further evaluate what breathing exercises may be able to bring as a new treatment strategy for AF patients.

A large percentage of patients with AF are overlooked in clinical trials. Clinical trials may omit significant patient groups. In future, the incorporation of patients' expectations would improve the identification of patients in AF candidates of clinical trials.