Effects of heart rate variability biofeedback on working memory: A systematic review

Working Memory (WM) is an essential component of Executive Functions, directly related to academic performance, cognitive regulation, and well-being. Heart Rate Variability Biofeedback (HRVB) has emerged as a promising intervention due to its efficacy in autonomic modulation and potential effects on cognitive function. This systematic review aimed to evaluate the available evidence on the relationship between HRVB and WM performance. A search was conducted in August 2025 in the Web of Science, PubMed, and PsycINFO databases, resulting in 59 identified studies, of which 10 met the inclusion criteria. The included studies revealed significant heterogeneity regarding intervention protocols, investigated populations, and WM measurement instruments. The findings were mixed: some studies reported significant improvements in working memory, especially in clinical populations such as veterans with Post-Traumatic Stress Disorder, while others did not observe consistent effects, particularly in older adults and healthy young adults. In physiological terms, nine of the ten studies recorded an increase in HRV after the intervention, suggesting efficacy in autonomic modulation. Despite this potential, the conclusions are still preliminary, as several studies had methodological limitations that limit the generalizability of the findings. In conclusion, although HRVB shows potential to positively influence working memory, future investigations with greater methodological rigor and standardized protocols are needed.