Dr. Job Mogire · Cardiologist, Carle Health
The Mogire Contraindication Framework
Almost no breathwork content tells you when to stop, or who should not start. This is the cardiologist\u2019s answer to that gap: three gates that say who should be careful, with which techniques, and why.
Most breathing techniques are safe for most people. There are real exceptions, and a blanket "breathwork is safe for everyone" is not honest. Work through the three gates before you choose a technique. If a gate applies to you, that is a conversation to have with your physician, not a reason for alarm.
Gate 1 of 3
Gate 1 · Absolute caution
Talk to your physician before starting any structured breathwork if you have:
- A diagnosed arrhythmia (atrial fibrillation, SVT, ventricular arrhythmia)
- Heart failure, any stage
- Severe COPD or hypoxic respiratory failure
- Epilepsy or a history of seizures (breath holds lower the seizure threshold)
- Pregnancy (avoid breath holds and extreme hyperventilation)
- Active psychosis or a dissociative disorder
- A recent cardiac event (heart attack, cardiac surgery, ablation) within six months
Gate 2 of 3
Gate 2 · Technique-specific caution
Wim Hof and hyperventilation methods
Never in or near water. Avoid in cardiovascular disease, pregnancy, and epilepsy.
Prolonged breath holds, over fifteen seconds
Avoid in hypertension, arrhythmia, and pregnancy.
High-volume cyclic hyperventilation (holotropic)
Avoid in cardiovascular disease, seizure disorders, severe anxiety, and trauma histories without clinical support.
If you take a beta-blocker
Your heart rate response to breathing is blunted and HRV biofeedback is less reliable. Slow breathing is still beneficial; the heart rate change will simply be smaller than expected.
Gate 3 of 3
Gate 3 · Universal stop signs
For everyone, with every technique:
- Stop if you feel chest pain, significant palpitations, or fainting. These need a physician.
- Stop if lightheadedness lasts beyond thirty seconds after a session. It may signal hyperventilation from incorrect technique, or an underlying condition.
- Never use breathwork as a substitute for emergency care or for prescribed medication.
EYANA is health education, not medical advice. It does not diagnose, treat, or replace your physician, and nothing here is a reason to start, stop, or change any medication or treatment. If you have a heart or lung condition, read the Mogire Contraindication Framework first and talk to your doctor. If you have chest pain, fainting, or a racing heart that will not settle, seek medical care.