The Effect of Yoga on Cardiac Sympathetic Innervation Evaluated by I-123 mIBG

The Effect of Yoga on Cardiac Sympathetic Innervation Evaluated by I-123 mIBG

The purpose of this study is to evaluate if yoga practice will reduce cardiac sympathetic activity and subsequently cardiac arrhythmias.

Subjects with reduced ejection fraction will be randomized to 8 weeks Yoga training (1 in class session and home practice) vs. no Yoga. They will undergo holter monitoring, cardiac device interrogation, and I-123 mIBG imaging at the beginning and end of the study.

Inclusion Criteria:

• Negative pregnancy test in females
• Ejection Fraction </= 40% assessed by echocardiogram within the last 12 months
• Stable dose of heart failure medications including afterload reducing medication such as ACE-I, ARB and hydralazine; beta blockers; digoxin and aldosterone antagonist for at least 4 months and no anticipated changes for 8 weeks. (i.e. no greater than a 50% dose change within the past month)
• Has an implantable pacemaker or ICD
• NYHA II-IV

Exclusion Criteria:

• pregnant or lactating female
• females without a pregnancy test
• co-administration of a positive inotrope (i.e. milrinone or dobutamine)
• history of significant medical non-compliance
• unwilling to adhere to the protocol
• Orthopedic limitation making yoga participation difficult
• Underlying cardiac rhythm other than sinus rhythm
• Recent history within 6 months prior to enrollment of unstable coronary artery disease (unstable angina, recent heart attack, recent revascularization, or decompensated heart failure)
• implantation of a cardiac resynchronization therapy device in the past 3 months.
• TIA, CVA, or major surgery in the past 3 months
• iodine or adreview (123-MIBG) allergy