Effect Of Relaxation Therapy On Cardiac Events After Myocardial Infarction: A 5-Year Follow-Up Study

Background.

Evidence suggests that breathing and relaxation therapy may influence cardiac events in persons after acute myocardial infarction (MI). The authors studied the effects of breathing and relaxation therapy on rates of cardiac events and cost effectiveness in past MI patients.

Study patients (n = 156) had a diagnosis of a recent myocardial infarction (within one month). These patients were chosen randomly to receive either exercise training plus relaxation therapy (relaxation group; n = 76) or exercise training only (control group; n = 80). Exercise training consisted of a 5-week, 30 minutes per session bicycle ergometer program (weekly frequency not reported). The relaxation program included individual instruction for one-hour a week for 6 weeks. This consisted of biofeedback in the recumbent position and breathing regulation instruction. The patients were encouraged to engage in similar activity for the rest of their lives after the initial training programs. The medical records of all study patients were evaluated at 2 and 5 years after discharge. The occurrence of major cardiac events and cardiac rehospitalizations in the two treatment groups was compared.

Results

At 5-year follow-up, 12 cardiac deaths had occurred, 5 in the relaxation group and 7 in the control group, reinfarction occurred in 10 and 12 patients, and cardiac surgery was performed in 2 and 11, respectively. In total, 15 (20%) and 26 (33%) patients, respectively, experienced at least one cardiac event (odds ratio [OR] for the relaxation group: 0.55; adjusted for risk factors OR 0.52. Regarding all cardiac rehospitalizations, in the relaxation group, 30 patients (39%) had experienced 52 cardiac events, for which the patients were hospitalized for a total of 476 days. In the control group, 38 patients (48%) had experienced 78 cardiac events (OR 0.72), comprising 719 days of hospitalization. The total number of hospitalizations was reduced by 31% as a result of relaxation instruction. Conclusions. In the long-term, the disease course after myocardial infarction is influenced favorably by giving relaxation therapy in addition to cardiac rehabilitation. The extra costs of the therapy are compensated by a decrease in hospitalization for cardiac problems.