The Effect of Biofeedback on Function in Patients with Heart Failure |
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Authors: | Kimberly S Swanson Richard N Gevirtz Milton Brown James Spira Ermina Guarneri Liset Stoletniy |
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Institution: | (1) The Everett Clinic, 1728 West Marine View Drive, Suite 106, Everett, WA 98201, USA;(2) California School of Professional Psychology at Alliant International University, 104 Daley Hall, 10455 Pomerado Road, San Diego, CA 92131, USA;(3) Psychology Center for Distributed Learning, Science and Engineering Group: RTI International, San Diego, CA, USA;(4) Scripps Center for Integrative Medicine, San Diego, CA, USA;(5) Loma Linda University Medical Center International Heart Institute, Loma Linda, CA, USA |
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Abstract: | Decreased HRV has been consistently associated with increased cardiac mortality and morbidity in HF patients. The aim of this
study is to determine if a 6-week course of heart rate variability (HRV) biofeedback and breathing retraining could increase
exercise tolerance, HRV, and quality of life in patients with New York Heart Association Class I-III heart failure (HF). Participants
(N = 29) were randomly assigned to either the treatment group consisting of six sessions of breathing retraining, HRV biofeedback
and daily practice, or the comparison group consisting of six sessions of quasi-false alpha-theta biofeedback and daily practice.
Exercise tolerance, measured by the 6-min walk test (6MWT), HRV, measured by the standard deviation of normal of normal beats
(SDNN), and quality of life, measured by the Minnesota Living with Congestive Heart Failure Questionnaire, were measured baseline
(week 0), post (week 6), and follow-up (week 18). Cardiorespiratory biofeedback significantly increased exercise tolerance
(p = .05) for the treatment group in the high (≥31%) left ventricular ejection fraction (LVEF) category between baseline and
follow-up. Neither a significant difference in SDNN (p = .09) nor quality of life (p = .08), was found between baseline and follow-up. A combination of HRV biofeedback and breathing retraining may improve exercise
tolerance in patients with HF with an LVEF of 31% or higher. Because exercise tolerance is considered a strong prognostic
indicator, cardiorespiratory biofeedback has the potential to improve cardiac mortality and morbidity in HF patients.
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Keywords: | Heart rate variability Biofeedback Heart Failure Exercise tolerance Functional status Quality of life Breathing retraining |
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