Background: Paroxysmal atrial fibrillation is associated with impaired health-related quality of life. Yoga has been suggested to improve health-related quality of life among patients with heart failure and hypertension. Aim: The aim of the study was to evaluate the effects of MediYoga, in respect of health-related quality of life, blood pressure, heart rate, as well as N-terminal pro b-type natriuretic peptide, among patients with symptomatic paroxysmal atrial fibrillation, compared with standard therapy or relaxation. Methods: Patients with symptomatic paroxysmal atrial fibrillation, n=132, were stratified for gender and randomised to MediYoga, a relaxation group or a control group, 44 patients per group with a 12-week follow-up. Health-related quality of life, blood pressure, heart rate and N-terminal pro b-type natriuretic peptide were assessed. Results: After 12 weeks, there were no differences in health-related quality of life between the groups. There were improvements in Short-Form Health Survey bodily pain, general health, social function, mental health and mental component summary scores within the MediYoga group (p=0.014, p=0.037, p=0.029, p=0.030, p=0.019, respectively). No change was seen in the relaxation and control groups. Systolic blood pressure decreased in the MediYoga group (134 +/- 18 to 127 +/- 13) compared with the control group (126 +/- 17 to 127 +/- 15, p=0.041); no difference compared with the relaxation group (131 +/- 17 to 125 +/- 12). Diastolic blood pressure decreased in the MediYoga group (79 +/- 9 to 74 +/- 9) compared with the control group (76 +/- 9 to 79 +/- 8, p=0.005); no difference compared with the relaxation group (76 +/- 9 to 77 +/- 8). There were no differences in heart rate and N-terminal pro b-type natriuretic peptide between the groups after 12 weeks. Conclusions: MediYoga improves health-related quality of life and decreases blood pressure in patients with paroxysmal atrial fibrillation. MediYoga may be used as a part of a self-management programme among patients with paroxysmal atrial fibrillation.