Heart and soul: the feeling body
Anthony Korner in Communicative Exchange, Psychotherapy and the Resonant Self, 2020
The associated physiology reflects these functions: when we inspire there is a temporary gate on vagal influence, functionally meaning a relative preparedness for activation or mobilization; while with expiration there is reinstatement of vagal influence, consistent with relaxation and receptive function (Appelhans & Luecken, 2006). Under non-stressed conditions these influences are small. Vocalization increases the effort of expiration and is associated with a shortened RR interval, but does not, in itself, exert a significant influence on RSA (Kotani et al., 2007). (The RR interval is the interval between successive R waves on electrocardiogram recordings.) This is consistent with vocalization and speech being activities compatible with a sense of social safety. In the context of an emotionally engaged psychotherapy, conversations occur that will, at times, have significant emotional content. This can put participants in the position of experiencing significant mobilization of the ANS and CRA. Indeed, these areas of emotional significance are likely to be important to the process of change (Schore, 2012). For both patient and therapist management of these states is crucial to the outcome of the therapy.
Experimental models and measurements to study cardiovascular physiology
Neil Herring, David J. Paterson in Levick's Introduction to Cardiovascular Physiology, 2018
Analysis of heart rate and BP by telemetry can be used to give an indication of spontaneous baroreflex sensitivity (by examining the relationship between changes in systolic BP and pulse interval), or heart rate variability. Many measures of heart rate variability exist. Any signal that fluctuates can be analysed to see how often the signal occurs at different frequencies, something known as a power spectral analysis. The high and low frequency components of heart rate variability have often been taken to reflect the activity of the autonomic nervous system. Other measures, such as the standard deviation of the ECG RR (or NN) inter val (SDNN), measure the overall heart rate variability that correlates with morbidity and mortality in human patients with heart failure. Heart rate variability is a controversial method of providing a quantitative measure of the contribution of the individual branches of the autonomic nervous system, particularly when the low frequency component or the low frequency/high frequency (LF/HF) ratio are viewed in isolation; conclusion should be limited to the relative balance between the two.
Depression, Anxiety, Stress, and Spirituality in Cardiovascular Disease
Stephen T. Sinatra, Mark C. Houston in Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Depression and anxiety may also be correlated with CVD through their influence on altering autonomic vascular tone. This has been most directly studied through the concept of heart rate variability (HRV). HRV is a measurement of R-R intervals and the cyclic variation that reflects autonomic balance between sympathetic and parasympathetic nervous system activity.52 Autonomic nervous system imbalance with increased sympathetic nervous system activation and decreased vagal tone has been correlated with CVD and risk of adverse cardiac events,52,169 through such mechanisms as triggering atherosclerosis and/or platelet aggregation, and leading to changes in lipid metabolism.53 Low HRV is related to poor cardiac outcomes and increased risk of post-MI mortality,54 and is correlated with sudden cardiac death even in those that have not been diagnosed with CVD.55
Wearable sensors to improve detection of patient deterioration
Published in Expert Review of Medical Devices, 2019
Meera Joshi, Hutan Ashrafian, Lisa Aufegger, Sadia Khan, Sonal Arora, Graham Cooke, Ara Darzi
The Philips Bio Sensor is small lightweight sensor measuring HR, RR, skin temperature, body posture, fall detection, single lead ECG, RR-interval and step count [30]. It is a wireless self-adhesive sensor worn on the chest. It weighs 12 g, and the size dimensions are 1 cm × 3.6 cm × 0.8 cm. During a normal ECG waveform, the R interval equates to a point corresponding to the peak of the QRS complex. The RR-interval in this context is the interval between successive R peaks on an ECG. The Philips Bio Sensor is disposable and has a battery life of 4 days. The sensor technology is ECG electrodes that detect heart rate, a thermistor to detect skin temperature and three axis accelerometer to detect motion [30]. The patient data is transmitted via Bluetooth to an IntelliVue Guardian Software tool which can integrate into electronic medical records and alert to smartphone devices. The sensor is both FA approved and CE marked. There are currently no research papers with the use of the sensor on the wards for continuous monitoring.
Effects of capacitive and resistive electric transfer and hot pack interventions on the autonomic nervous system in young women
Published in Electromagnetic Biology and Medicine, 2022
Haruna Matsushita, Momoko Nagai- Tanima, Tomoki Aoyama, Masatoshi Nakamura
ECG measurements included heart rate (HR) and RR intervals using a Cardiofax Velectrocardiograph (Cardiofax V, Nihon Kohden, Tokyo, Japan). Electrodes were applied only to the upper left and right limbs, and lower limbs for limb induction. The HR and RR intervals were calculated from electrocardiograms over a 3 min period. The RR interval represents heart rate variability, which is regulated by the autonomic nervous system -especially the parasympathetic nervous system (Siennicka et al. 2019). In this study, the coefficient of variation (CV), which is the coefficient of variation of the RR interval, was used as an index of autonomic nervous activity. When parasympathetic nervous activity is dominant (where the body is in a relaxed state), the CV value increases; when sympathetic nervous activity is dominant, the CV value decreases (Park et al. 2018). The average HR and average RR interval over 3 min were used in analyses.
Circadian rhythm of airways caliber and its autonomic modulation
Published in Chronobiology International, 2020
Manish Goyal, Arun Goel, Ruchi Singh, Nilotpal Chowdhury, Narsingh Verma, Sunita Tiwari, Kishore Kumar Deepak
ECG signals were first de-noised using sym4 wavelet (decomposition to level 5 and reconstruction using wavelet coefficients at 4 and 5), and then R wave peaks were detected. ECG data and RR tachograms were plotted and visually inspected for ectopic and missed beats that were later corrected with MATLAB 2017a. The RR interval sequences from the 5-min records were analyzed for time-domain measures, spectral parameters (using Loomb’s Scargle method) and nonlinear analysis (using Poincare plot). Mean RR interval, standard deviation of normal RR intervals (SDNN), root mean square of successive differences (RMSSD) and proportion of normal RR intervals differing by more than 50 ms to the total number of normal RR intervals (PNN50) were determined for time-domain measures. For spectral-domain measures, low frequency (LF) and high frequency (HF) variance were determined, and the ratio of LF/HF normalized power was taken as an index of sympatho-vagal balance. For nonlinear measures, SD1 and SD2 were determined from Poincare plots. HRV analysis from RR interval data was carried out using HRVSOFT software (developed in house at the autonomic function test laboratory, AIIMS, Delhi), and results were validated with codes adapted from PhysioNet Cardiovascular Signal Toolbox for MATLAB (Vest et al. 2018).
Related Knowledge Centers
- Bradycardia
- Carbon Dioxide
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