Differences in beginner and expert neurointerventionalists" heart rate variability during simulated...

Area of Science:

• Cardiovascular physiology
• Medical simulation
• Neurointerventional radiology

Background:

• Heart rate variability (HRV) correlates with performance in simulated and real-world conditions.
• Assessing HRV as a workload indicator is crucial for understanding the impact of work experience.
• Previous research links HRV to performance, necessitating investigation into its relationship with expertise in neurointerventional radiology.

Purpose of the Study:

• To investigate differences in HRV metrics between expert and beginner neurointerventionalists.
• To determine the impact of work experience on cardiovascular workload during simulated endovascular procedures.

Main Methods:

• Six beginners and five experts performed 10 diagnostic angiographies on a VIST simulator.
• Collected data included procedure time, fluoroscopy time, contrast volume, HRV, and NASA-task load index.
• Statistical analyses included t-tests, Mann-Whitney-U tests, and multivariate regression to compare groups and assess influencing factors.

Main Results:

• Experts exhibited significantly different HRV time-domain metrics (decreased RMSSD, NN50, pNN50) compared to beginners.
• Frequency-domain analysis revealed significant differences in the LF/HF ratio, with increased high-frequency components in experts.
• These HRV differences suggest distinct physiological responses to workload between novice and experienced neurointerventionalists.

Conclusions:

• Significant differences in HRV were observed between expert and beginner neurointerventionalists during simulated procedures.
• The decreased HRV in experts may serve as a cardiovascular surrogate for the cognitive effort invested in performance.
• Findings align with existing research on vagal influences and cognitive-executive performance.