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Reviews in Cardiovascular Medicine  2019, Vol. 20 Issue (3): 129-137     DOI: 10.31083/j.rcm.2019.03.517
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Modulation of the autonomic nervous system through mind and body practices as a treatment for atrial fibrillation
M. Usmaan Bashir1, *(), Anjali Bhagra2, Suraj Kapa3, Christopher J. McLeod4
1 Department of Medicine Mayo Clinic College of Medicine 200 First Street SW Rochester, MN, 55905, USA
2 Division of General Internal Medicine Mayo Clinic College of Medicine 200 First Street SW Rochester MN, 55905, USA
3 Department of Cardiovascular Diseases Mayo Clinic College of Medicine 200 First Street SW Rochester, MN, 55905, USA
4 Department of Cardiovascular Diseases Mayo Clinic 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
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Atrial fibrillation is the most common symptomatic arrhythmia that is associated with stroke. Contemporary management of the disease is focused on anticoagulation to prevent stroke, coupled with catheter ablation to limit symptoms and prevent deleterious cardiac remodeling. Emerging data highlights the importance of lifestyle modification by managing sleep apnea, increasing physical activity, and weight loss. There is significant data that supports a link between the autonomic nervous system, arrhythmia development, and atrial fibrillation therapy. It is likely that lifestyle modification through these techniques that are aimed to reduce stress may also mediate atrial fibrillation development through this mechanism. This review examines how mind and body practices such as meditation, yoga, and acupuncture may influence the autonomic nervous system and mitigate atrial fibrillation progression and regression. Available evidence from molecular and anatomical levels through to clinical observations and translational clinical trials were scrutinized and a case established for these interventions as potential powerful mediators of anti-arrhythmic benefit.

Key words:  Atrial fibrillation      yoga      meditation      autonomic nervous system     
Submitted:  01 July 2019      Accepted:  17 September 2019      Published:  30 September 2019     

  • Department of Cardiovascular Diseases Mayo Clinic
  • Department of Medicine Mayo Clinic College of Medicine
  • Department of Cardiovascular Diseases Mayo Clinic College of Medicine

*Corresponding Author(s):  M. Usmaan Bashir     E-mail:

Cite this article: 

M. Usmaan Bashir, Anjali Bhagra, Suraj Kapa, Christopher J. McLeod. Modulation of the autonomic nervous system through mind and body practices as a treatment for atrial fibrillation. Reviews in Cardiovascular Medicine, 2019, 20(3): 129-137.

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Figure 1.  Extrinsic and intrinsic autonomic nervous system, reprinted from Witt et al., (2017) by permission of Oxford University Press

Figure 2.  Acupuncture sites used in ACU-AF trial (A) PC5, PC6, and HT7. (B) TF4. (C) ST36 and ST37. Reprinted from Park et al. (2015) which was published under a Creative Commons license.

Figure 3.  Acupuncture needling points, reprinted from Lomuscio et al. (2011) Copyright 2010 by Wiley Periodicals, Inc. Reprinted by permission of John Wiley & Sons, Inc.

Figure 4.  The five domains of complementary and alternative medicine, Reprinted from Viscuse et al. (2017) by permission of Wolters Kluwer Health, LWW.

Figure 5.  Data from the Yoga My Heart trial, Reprinted from (Lakkireddy et al., 2013) with permission from Elsevier

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