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Meditation for Improved Clinical Outcomes in Patients with Implantable Defibrillators for Heart Failure- Pilot Study
Dash Aditee1, Malhotra Pankaj1, Beri Neil1
1Division of Cardiovascular Medicine.
Insights
Meditation may improve survival and reduce arrhythmias in congestive heart failure patients with implantable cardioverter-defibrillators (ICD). This pilot study suggests Vipassana meditation offers potential benefits for cardiac event reduction.
Area of Science:
- Cardiology
- Psychoneuroimmunology
- Medical Interventions
Background:
- Sympathetic nervous system activation is linked to adverse outcomes in congestive heart failure (CHF).
- Emotional reactivity may contribute to arrhythmias in CHF patients.
- Meditation is explored as a strategy to mitigate sympathetic overactivity and reduce cardiac events.
Purpose of the Study:
- To investigate the effect of Vipassana meditation on arrhythmias and clinical events in patients with CHF and implantable cardioverter-defibrillators (ICD).
- To assess if meditation can reduce emotional reactivity and its impact on cardiac health.
Main Methods:
- A randomized controlled trial comparing Vipassana meditation to usual care in CHF patients with ICDs.
- Meditation group received structured classes and daily practice recommendations.
- Atrial and ventricular arrhythmias, and cardiac events were monitored via ICD and clinical follow-up.
Main Results:
- Patients in the meditation group showed a trend towards improved survival (88% vs. 67%).
- Fewer sustained atrial fibrillation episodes (0.9 vs. 2.5) and ventricular tachycardia (25% vs. 55%) occurred in the meditation group.
- Reduced need for amiodarone and VT ablation was observed in the meditation arm.
Conclusions:
- This pilot study indicates a potential benefit of meditation in improving survival and reducing arrhythmias in CHF patients with ICDs.
- Long-term follow-up suggests meditation may be a valuable complementary therapy for managing CHF.
- Further research is warranted to confirm these findings in larger cohorts.
Background:
Sympathetic activation is associated with congestive heart failure (CHF) and leads to adverse clinical events.We hypothesized that meditation by reducing emotional reactivity would have beneficial effect in reducing arrhythmias compared to control patients.
Methods:
Patients known to have CHF and implantable cardioverter defibrillators (ICD) were randomized to Vipassana meditation or usual care control group. Meditation group underwent meditation classes three times during the first week, thereafter every once two weeks. They were encouraged to practice meditation at least once everyday. The ICD was followed by clinic/ remote visits. Atrial (AA) and ventricular arrhythmias (VA) as well cardiac events were assessed in follow up. Chi square test was used to compare nominal variables and t test for continuous variables.
Results:
Patients (n=25, 65% male, mean LVEF 25%, HTN 38%, Diabetes 12%, coronary artery disease 38%, NYHA class 2.2) were followed for 79 + 36 months. Comparing meditation vs control, survival was higher (88%vs 67%); there was less cumulative sustained AF episodes (mean 0.9, IQR 0-1 vs 2.5, IQR 2-4, p=0.045), sustained VT occurred (25% vs 55%, amiodarone use (none vs 44%), and VT ablation in 6.6% vs 33% in the meditation group.
Conclusions:
In this first pilot study of meditation in CHF patients with ICD, during long term follow up, there is a trend for improved survival and reduced arrhythmias in patients randomized to meditation.
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