The Effect of Yoga on Cardiac Sympathetic Innervation Evaluated by I-123 mIBG

Subjects with reduced ejection fraction will be randomized to 8 weeks Yoga training (1 in
class session and home practice) vs. no Yoga. They will undergo holter monitoring, cardiac
device interrogation, and I-123 mIBG imaging at the beginning and end of the study.

Inclusion Criteria:

- Negative pregnancy test in females

- Ejection Fraction
- Stable dose of heart failure medications including afterload reducing medication such
as ACE-I, ARB and hydralazine; beta blockers; digoxin and aldosterone antagonist for
at least 4 months and no anticipated changes for 8 weeks. (i.e. no greater than a 50%
dose change within the past month)

- Has an implantable pacemaker or ICD

- NYHA II-IV

Exclusion Criteria:

- pregnant or lactating female

- females without a pregnancy test

- co-administration of a positive inotrope (i.e. milrinone or dobutamine)

- history of significant medical non-compliance

- unwilling to adhere to the protocol

- Orthopedic limitation making yoga participation difficult

- Underlying cardiac rhythm other than sinus rhythm

- Recent history within 6 months prior to enrollment of unstable coronary artery disease
(unstable angina, recent heart attack, recent revascularization, or decompensated
heart failure)

- implantation of a cardiac resynchronization therapy device in the past 3 months.

- TIA, CVA, or major surgery in the past 3 months

- iodine or adreview (123-MIBG) allergy