Mobile Heart Rate Variability Biofeedback as a Complementary Intervention After Myocardial Infarction: a Randomized Controlled Study

Faculty/Professorship: University of Bamberg  ; Personality Psychology and Psychological Assessment  
Author(s): Limmer, Anja  ; Laser, Martin; Schütz, Astrid  
Title of the Journal: International journal of behavioral medicine : the official journal of the International Society of Behavioral Medicine
ISSN: 1532-7558
Publisher Information: Boston, MA : Springer
Year of publication: 2021
Pages: 10
Language(s): English
Published online: 18 May 2021
DOI: 10.1007/s12529-021-10000-6
Background: To enhance effective prevention programs after myocardial infarction (MI), the study examined the effects and feasibility of mobile biofeedback training on heart rate variability (HRV-BF).
Methods: Forty-six outpatients aged 41 to 79 years with a documented MI were randomized to HRV-BF versus usual care. Generalized estimating equations (GEE) analyses were performed to test improvements in measures of short- and long-time HRV, namely, the standard deviation of the normal-to-normal intervals (SDNN) and well-being after 12 weeks of HRV-BF.
Results: There were intervention effects for short-time HRV (d > 0.4, p < 0.04), which were partly replicated in the GEE models that accounted for control variables: In the HRV-BF group, the high frequency HRV (group x time interaction: β = 0.59, p = 0.04) compensated for significantly lower baseline levels than the group with usual care. In an optimal dose sample (on average two HRV-BF sessions a day), SDNN significantly increased after HRV-BF (p = 0.002) but not in the waitlist control group. Compensatory trends of HRV-BF were also found for high-frequency HRV and self-efficacy. No adverse effects of the intervention were found but neither were effects on long-time HRV measures.
Conclusion: The results showed the feasibility of self-guided HRV-BF for almost all post-MI patients. HRV-BF as an adjunctive behavioral treatment increased HRV, which is an indicator of lower cardiovascular risk, and self-efficacy, which suggests heightened psychological resilience. These benefits warrant confirmation and tests of sustainability in larger studies.
GND Keywords: Herzinfarkt; Herzfrequenzvariabilität; Biofeedback; Sekundärprävention
Keywords: Myocardial Infarction, Heart Rate Variability Biofeedback, Secondary Prevention, Risk factors, Self-Efficacy
DDC Classification: 610 Medicine & health  
RVK Classification: YB 9515   
Peer Reviewed: Ja
International Distribution: Ja
Type: Article
Release Date: 30. July 2021