Effectiveness and safety of yoga-based interventions in the management of atrial fibrillation: a systematic review

Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias globally. Yoga, an ancient mind–body practice, is increasingly recognized as a safe adjunctive therapy. This review systematically evaluates evidence on the effectiveness of yoga-based interventions in improving clinical and patient-reported outcomes among individuals with AF. A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library was conducted from inception to July 2025 using predefined AF- and yoga-related terms. Eligible studies included adults with AF receiving yoga in addition to standard care and reporting outcomes on arrhythmia symptoms, cardiovascular parameters, quality of life, or psychological health. Data extraction followed a standardized template. Risk of bias was assessed using ROBINS-I for non-randomized studies and RoB 2 for randomized trials. Owing to heterogeneity in study design and outcomes, a narrative synthesis was undertaken. Of 685 records screened, four studies met the inclusion criteria—three randomized controlled trials and one cohort study—encompassing 244 patients with paroxysmal AF. Yoga interventions varied in style, duration, and delivery but were consistently used adjunctively. Two studies demonstrated significant reductions in AF symptom frequency, and three reported decreases in resting heart rate and blood pressure. All studies observed improved quality of life, and two reported reductions in depression and anxiety. No adverse events were documented, and adherence to yoga programs was high. The cohort study was rated as having moderate risk of bias, while randomized trials showed “some concerns.” Yoga, when combined with standard care, may reduce symptom burden and enhance cardiovascular, psychological, and quality-of-life outcomes in patients with paroxysmal AF. Although promising, current evidence remains limited, highlighting the need for larger, rigorously designed trials with standardized protocols and long-term follow-up.