Abstract
Psychological stress is a well-established risk factor for cardiovascular disease (CVD). Heart rate variability (HRV)-biofeedback could significantly reduce stress levels and improve autonomic nervous system function and cardiovascular endpoints. We aimed to systematically review the literature to investigate the impact of HRV modulation through HRV-biofeedback on clinical outcomes in patients with CVD. A literature search was performed in the following databases: MEDLINE (PubMed), Embase, and Cochrane from the inception until 1 October 2021. Patients in the HRV-biofeedback group had significantly lower rates of all-cause readmissions than patients who received psychological education (respectively, p = 0.028 and p = 0.001). Heart failure following HRV-biofeedback displayed an inverse association with stress and depression (respectively, p = 0.022 and p = 0.033). When stratified according to left ventricular ejection fraction (LVEF), patients with LVEF ≥ 31% showed improved values of the 6 min walk test after HRV-biofeedback interventions (p = 0.05). A reduction in systolic and diastolic blood pressure associated with HRV-biofeedback was observed (p < 0.01) in pre-hypertensive patients. HRV-biofeedback had beneficial effects on different cardiovascular diseases documented in clinical trials, such as arterial hypertension, heart failure, and coronary artery disease. A standard breathing protocol should be applied in future studies to obtain equivalent results and outcomes. However, data regarding mortality in patients with coronary artery disease are scarce and need further research.
Highlights
IntroductionHeart rate variability (HRV) represents a non-invasive, indirect parameter of autonomic nervous system function
Introduction published maps and institutional affilHeart rate variability (HRV) represents a non-invasive, indirect parameter of autonomic nervous system function
We aimed to systematically review the literature to investigate the impact of HRV modulation through HRV-biofeedback on clinical outcomes in patients with cardiovascular diseases
Summary
Heart rate variability (HRV) represents a non-invasive, indirect parameter of autonomic nervous system function. It reflects the fluctuation in time of successive sinus heartbeats related to the balance between parasympathetic and sympathetic nervous systems. Solid evidence presented HRV as a surrogate correlative marker of the deep, complex interaction between the nervous system (brain) and the heart rhythm [1,2,3]. The interest in HRV assessment has increased in the last few years. HRV is not measured as a single value, but rather as a variety of time- and frequency-domain parameters, as well as non-linear methods of measurement. Among time-domain parameters, the most used in clinical trials are the iations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
