This study is a two-arm randomized parallel group trial designed to compare the effects of alternate nostril breathing vs diaphragmatic breathing on oxygen saturation and Heart-rate variability in hemodynamically stable post-PCI patients. Participants will be randomly allocated in a 1:1 ratio to alternate nostril breathing or diaphragmatic breathing and will receive the allocated intervention for 2 consecutive days with three supervised sessions per day in addition to routine post-PCI care. Oxygen saturation will be assessed using a pulse oximeter and heart-rate variability will be assessed using a Polar H10 sensor at baseline and after the intervention. The study will determine whether there is a difference between two breathing interventions in the prescribed outcome measures.
Adults aged 44-75 years
Hemodynamically stable post-PCI patients with systolic blood pressure>90 mmHg, diastolic BP 50-100mmHg Heart-rate 60-100 beats/min and no ongoing chest pain or signs of acute clinical instability.
Oxygen saturation >92% on room air
Able to follow simple verbal instructions and perform the breathing exercises.
Ongoing myocardial ischemia, unstable angina, significant arrythmia or requirement for inotropic/vasopressor support.
Cardiogenic shock or severe heart failure (NYHA class IV)
Recent thoracic surgery or chest wall injury limiting rib expansion or deep breathing.
Cardiac implantable electronic device (pacemaker/ICD) with pacing dependency or an implanted ventricular assist device.
Parallel
Alternate Nostril Breathing
BehavioralNon-pharmacological breathing interventions administered under physiotherapist supervision for 2 consecutive days with three sessions per day in addition to routine post-PCI care.
Diaphragmatic breathing
Other interventionParticipants assigned to this group will perform diaphragmatic breathing under physiotherapist supervision in addition to routine post-PCI care. The participant will lie supine or sit upright with the back supported, with one hand on the upper chest and the other on the abdomen below the rib cage. The participant will inhale slowly through the nose while allowing the abdomen to rise and then exhale slowly through pursed lips while allowing the abdomen to fall. Post-PCI Day 0 : 3 sessions/day approximately 15mins/session,10 repetitions. Post-PCI Day 1 :3 supervised sessions/day approximately 20 minutes/session, 15 repetitions.
Change in Oxygen saturation
Change in peripheral oxygen saturation (SpO₂) from baseline to the specified post-intervention assessment time point, measured using a pulse oximeter. Oxygen saturation will be recorded as a percentage (%) and compared between baseline and post-intervention measurements.
Change in Heart Rate Variability (HRV)
Change in heart rate variability from baseline to the specified post-intervention assessment time point, assessed using a validated heart rate/ECG monitoring device. Heart rate variability will be evaluated using predefined HRV parameters, such as time-domain and/or frequency-domain measures, as applicable to the study protocol.
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