Acute Effect of Kapalbhati Yoga on Cardiac Autonomic Control Using Heart Rate Variability Analysis in Healthy Male Individuals

Abstract

Kapalbhati is well known for improving cardiovascular health. But there are some reports of heart attacks while practising kapalbhati. We hypothesize that ill-effect of kapalbhati could be because of autonomic dysfunction to heart. In the present study, we aim to understand the acute effect of kapalbhati yoga on heart rate dynamics using heart rate variability (HRV) analysis. Resting heart rate (HR) varies widely in different individuals and during various physiological stresses, particularly, exercise it can go up to three-fold. These changes in heart rate are known as heart rate variability (HRV). Variability in heart rate reflects the control of autonomic system on the heart and which can be determined during brief periods of electrocardiographic (ECG) monitoring. HRV measures the effect of any physical exercise on the heart rate using time- and frequency-domain methods. Frequency-domain method involves power spectral analyses of the beat-to-beat intervals (R-R intervals) variability data. When total power vs. frequency, fast fourier transform analysis of R-R intervals data is done, it shows three well-defined peaks/rhythms in every individual, which contain different physiological information. Thus, the total spectral power of R-R intervals data can be divided into three components or bands viz., the very low frequency (VLF) band, the low-frequency (LF) band and the high frequency (HF) band. VLF represent very long time-period physiological phenomenon like thermoregulation, circadian rhythms etc. and thus are not seen in short-term recordings like in this work. LF band power represents long period physiological rhythms in the frequency range of 0.05- 0.15 Hz and LF band power increases as a consequence of sympathetic activation. HF band represent physiological rhythms in the frequency range of 0.15-0.5 Hz and they are synchronous with the respiration rate, and arise due to the intrathoracic pressure changes and mechanical vibrations caused by the breathing activity. In this work, twenty healthy male volunteers were trained in kapalbhati yoga and their ECG waveforms (2 min.) were obtained while doing kapalbhati (breathing at 1 Hz frequency for 2 min.) and were compared with the baseline (just 2 min. before the start) and post-kapalbhati (immediately 2 min. after completing the practice) HRV data. Our results showed a significant decrease in the time-domain measures i.e., NN50, pNN50 and the mean heart rate interval during-kapalbhati when compared statistically to the respective before practice or “pre”-kapalbhati (p < 0.05, student’s paired t-test) values. Frequency-domain indices showed that during-kapalbhati there is a significant increase (~48%) in the LF band power which suggests sympathetic activation and a significant increase (~88%) in the low frequency to the high frequency power ratio (LF/HF ratio) which indicates sympathetic system predominance. A significant decrease (~63%) in the HF component was also noted during-kapalbhati as compared to the “pre-kapalbhati” values which shows decrease in parasympathetic tone. Thus, these results suggest that during-kapalbhati there is drastic increase of sympathetic tone whereas parasympathetic activity is reduced. We propose these changes in autonomic system control on heart are responsible for the myocardial ischemic attacks induced during kapalbhati in some individuals.