Related Experiment Video
Updated: Jun 25, 2026
04:20
Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
Published on: October 1, 2019
The effect of biofeedback on function in patients with heart failure
Kimberly S Swanson1, Richard N Gevirtz, Milton Brown
1The Everett Clinic, Everett, WA 98201, USA. kswanson@everettclinic.com
Applied Psychophysiology and Biofeedback
|February 12, 2009
Summary
Heart rate variability (HRV) biofeedback and breathing retraining improved exercise tolerance in heart failure (HF) patients with higher left ventricular ejection fraction (LVEF). This intervention shows potential for reducing cardiac mortality and morbidity.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Decreased heart rate variability (HRV) is linked to increased cardiac mortality and morbidity in heart failure (HF) patients.
- Exercise tolerance is a critical prognostic indicator in HF management.
Purpose of the Study:
- To investigate the efficacy of a 6-week HRV biofeedback and breathing retraining program.
- To assess improvements in exercise tolerance, HRV, and quality of life in HF patients (NYHA Class I-III).
Main Methods:
- A randomized controlled trial with 29 HF patients.
- Treatment group: HRV biofeedback and breathing retraining.
- Comparison group: Quasi-false alpha-theta biofeedback.
- Assessments: 6-minute walk test (6MWT), standard deviation of normal to normal beats (SDNN), Minnesota Living with Congestive Heart Failure Questionnaire at baseline, week 6, and week 18.
Main Results:
- Cardiorespiratory biofeedback significantly increased exercise tolerance (p = .05) in the treatment group with LVEF ≥31% from baseline to follow-up.
- No significant differences were observed in SDNN (p = .09) or quality of life (p = .08) between groups.
- The intervention showed a trend towards improvement in these measures.
Conclusions:
- A combination of HRV biofeedback and breathing retraining may enhance exercise tolerance in HF patients with LVEF ≥31%.
- Cardiorespiratory biofeedback holds potential for improving cardiac outcomes by enhancing exercise capacity in HF patients.
Related Concept Videos
01:22Heart Failure Drugs: β-Blockers
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
01:17Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
01:30Heart Failure VII: Nursing Interventions
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...