INTRODUCTION: The aim of this study was to examine the effect of yoga on heart rate variability in patients with breast cancer in an outpatient rehabilitation program. MATERIAL AND METHODS: Eighty-four patients with breast cancer were eligible for this study. After the exclusion of 7 women, 77 participants were randomly allocated to a yoga exercise program (group A, n = 33) and Pilates exercise program (group B, n = 44). Heart rate variability parameters were evaluated at baseline, after six and twelve months of yoga exercises. RESULTS: After twelve months of performing yoga exercises, standard deviation of the normal-to-normal intervals (SDNN) improved by 5.53 ms (p < 0.001), square root of the mean of the squared differences between adjacent normal RR interval (RMSSD) improved by 4.91 ms (p < 0.01), total power (TP) improved by 279.78 ms2 (p < 0.001), very low frequency (VLF) improved by 109.76 ms2 (p < 0.01), low frequency (LF) improved by 88.38 ms2 (p < 0.01), high frequency (HF) improved by 77.60 ms2 (p < 0.05), and stress index (Si) improved by 137.24 cu (p < 0.01). Based on the results after 12 months, women in group A showed significantly better results compared to group B in SDNN by 3.28 ms (p < 0.05), RMSSD by 3.34 ms (p < 0.05), TP by 170.33 ms2 (p < 0.05), HF by 64.33 (p < 0.05), and Si by 56.49 cu (p < 0.05). CONCLUSIONS: Performing the yoga exercise program resulted in an increase of the parasympathetic and baroreflex effects on the cardiovascular system and a decrease in the tonic effects of the sympathetic nervous system. Yoga should be considered as an effective tool in normalizing the functional state of the autonomic nervous system.

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