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HRV
HRV
Clinicians
Phyllis K. Stein, Ph.D.
Research Associate Professor of
Medicine and Director, Heart Rate
Variability Laboratory
Washington University School of
Medicine
St. Louis, MO
The Big Picture
Heart rate is under both sympathetic (SNS)
and parasympathetic (PNS) control.
Rapid fluctuations in heart rate usually reflect
PNS control only (respiratory sinus
arrhythmia).
Therefore, changes in heart rate over time
provide a window onto autonomic
physiology.
Analysis of heart rate variability (HRV)
quantifies these changes over time.
Parasympathetic
Nervous system
Cardiac output
Heart Rate
Blood pressure
Renin angiotensin
system
Sympathetic
Nervous system
One rhythm
5 seconds/cycle or
12 times/min
5 seconds/cycle=
1/5 cycle/second
1/5 cycle/second=
0.2 Hz
What are the Underlying Rhythms?
HF peak
0 0.20 Hz 0.40 Hz
o Beta-blockers
o ACE inhibitors in CHF
o Digoxin?
Cardiac rehab?
How Can HRV Be Increased?
Lifestyle modifications:
o Smoking cessation
o Weight loss
o Exercise
o Stress management
o Lipid lowering?
o Glycemic control
Final Thoughts
Analysis of HRV is a non-invasive method
for identifying abnormalities in cardiac
autonomic modulation.