Heart Rate Variability Biofeedback Psychophysiological Rehabilitation in Coronary Artery Disease Patients: State of Heart as the State of Brain

Abstract

Introduction: Psychological therapies in cardiac rehabilitation programs were found to be effective for patients with Coronary Artery Disease (CAD). Heart Rate Variability Biofeedback (HRVBF) is a behavioural neuro-cardiac intervention designed as a natural oscillation between the breathing cycle and Heart Rate (HR), also known as refractory sinus rhythm biofeedback. Aim: To find the potential effects of heart rate variability biofeedback for psychophysiological rehabilitation in coronary artery disease patients. Materials and Methods: In this systematic review included five databases (PubMed, Scopus, web of science, and Google Scholar) were searched for publications between January 2011 and December 2021. Randomised control trials published in the English language, done on the effect of HRV-BF on psychophysiological rehabilitation in CAD, were included. High-quality experimental trials were chosen for the study, using Arksey and O’Malley framework. The records were screened against eligibility criteria and methodological quality analysis was done using Downs and black checklist. Results: Overall, 11,048 articles were extracted, from which 56 records were screened, and three randomised control trials were included in the study. All the three studies scored within a range of 20 to 25, with good methodological quality. They demonstrate practical feasibility of heart rate variability biofeedback device with both short-term and long-term effect on psychophysiological rehabilitation in CAD patients. Conclusion: This systematic review showed the potential effects of HRV-BF for psychophysiological rehabilitation in CAD patients. Patients have reported the benefits of HRV-BF therapies by patient-reported as well as therapies reported outcome measures.