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- Title
Mobile Heart Rate Variability Biofeedback as a Complementary Intervention After Myocardial Infarction: a Randomized Controlled Study.
- Authors
Limmer, Anja; Laser, Martin; Schütz, Astrid
- Abstract
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 equation (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 × 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. Trial Registration: The trial has not been registered due to its starting point in 2017 predating the publication of the applicable CONSORT extension for reporting social and psychological intervention trials in 2018.
- Subjects
DISEASE relapse prevention; STRUCTURAL equation modeling; WELL-being; CARDIOVASCULAR diseases risk factors; MOBILE apps; MYOCARDIAL infarction; PATIENT satisfaction; MEDICAL care; PHYSIOLOGICAL control systems; RANDOMIZED controlled trials; CARDIOVASCULAR system; SELF-efficacy; PREVENTIVE health services; HEART beat; PATIENT education; ALTERNATIVE medicine; STATISTICAL sampling; ADVERSE health care events
- Publication
International Journal of Behavioral Medicine, 2022, Vol 29, Issue 2, p230
- ISSN
1070-5503
- Publication type
Article
- DOI
10.1007/s12529-021-10000-6