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The development of a new tool, analytic device, or approach frequently facilitates rapid growth in scientific understanding, although the process is seldom linear. The study of heart rate variability (HRV) defined as the extent to which beat-to-beat variation in heart rate varies, is a rapidly maturing paradigm that integrates health and wellness observations across a wide variety of biomedical and psychosocial phenomena and illustrates this nonlinear path of development. The utility of HRV as an analytic and interventive technique goes far beyond its original application as a robust predictor of sudden cardiac death. This Research Topic aims to provide a conceptual framework to use in exploring the utility of HRV as a robust parameter of health status, using a broad and inclusive definition of ‘health’ and ‘well-being’. From the broadest perspective, current biomedical science emerged from shamanistic and religious healing practices and empirically observed interventions made as humans emerged from other hominins. The exponential growth of physics, chemistry and biology provided scientific support for the model emphasizing pathology and disorders. Even before the momentous discovery of germ theory, sanitation and other preventive strategies brought about great declines in mortality and morbidity. The revolution that is currently expanding the biomedical model is an integrative approach that includes the wide variety of non-physio/chemical factors that contribute to health. In the integrative approach, health is understood to be more than the absence of disease and emphasis is placed on optimal overall functioning, within the ecological niche occupied by the organism. This approach also includes not just interventive techniques and procedures, but also those social and cultural structures that provide access to safe and effective caring for sufferers. Beyond the typical drug and surgical interventions - which many identify with the Western biomedical model that currently enjoys an unstable hegemony - such factors also include cognitive-behavioral, social and cultural practices such as have been shown to be major contributors to the prevention and treatment of disease and the promotion of health and optimal functioning. This Integrative Model of Health and Well-being also derives additional conceptual power by recognizing the role played by evolutionary processes in which conserved, adaptive human traits and response tendencies are not congruent with current industrial and postindustrial global environmental demands and characteristics. This mismatch contributes to an increasing incidence of chronic conditions related to lifestyle and health behavior. Such a comprehensive model will make possible a truly personalized approach to health and well-being, including and going far beyond the current emphasis on genomic analysis, which has promised more that it has currently delivered. HRV offers an inexpensive and easily obtained measure of neurovisceral functioning which has been found to relate to the occurrence and severity of numerous physical disease states, as well as many cognitive-behavioral health disorders. This use of the term neurovisceral refers to the relationships between the nervous system and the viscera, providing a more focused and specific conceptual alternative to the now nearly archaic “mind-body” distinction. This awareness has led to the recent and growing use of HRV as a health biomarker or health status measure of neurovisceral functioning. It facilitates studying the complex two way interaction between the central nervous system and other key systems such as the cardiac, gastroenterological, pulmonary and immune systems. The utility of HRV as a broad spectrum health indicator with possible application both clinically and to population health has only begun to be explored. Interventions based on HRV have been demonstrated to be effective evidence-based interventions, with HRV biofeedback treatment for PTSD representing an empirically supported modality for this complex and highly visible affliction. As an integral measure of stress, HRV can be used to objectively assess the functioning of the central, enteric and cardiac nervous systems, all of which are largely mediated by the vagal nervous complex. HRV has also been found to be a measure of central neurobiological concepts such as executive functioning and cognitive load. The relatively simple and inexpensive acquisition of HRV data and its ease of network transmission and analysis make possible a promising digital epidemiology which can facilitate objective population health studies, as well as web based clinical applications. An intriguing example is the use of HRV data obtained at motor vehicle crash sites in decision support regarding life flight evacuations to improve triage to critical care facilities. This Research Topic critically addresses the issues of appropriate scientific and analytic methods to capture the concept of the Integrative Health and Well-being Model. The true nature of this approach can be appreciated only by using both traditional linear quantitative statistics and nonlinear systems dynamics metrics, which tend to be qualitative. The Research Topic also provides support for further development of new and robust methods for evaluating the safety and effectiveness of interventions and practices, going beyond the sometimes tepid and misleading “gold standard” randomized controlled clinical trial.
The Poincaré plot (named after Henri Poincaré) is a popular two-dimensional visualization tool for dynamic systems due to its intuitive display of the dynamic properties of a system from a time series. This book presents the basis of Poincaré plot and focus especially on traditional and new methods for analysing the geometry, temporal and spatial dynamics disclosed by the Poincaré plot to evaluate heart rate variability (HRV). Mathematical descriptors of Poincaré plot have been developed to quantify the autonomic nervous system activity (sympathetic and parasympathetic modulation of heart rate). Poincaré plot analysis has also been used in various clinical diagnostic settings like diabetes, chronic heart failure, chronic renal failure and sleep apnea syndrome. The primary aims of quantification of the Poincaré plots are to discriminate healthy physiological systems from pathological conditions and to classify the stage of a disease. The HRV analysis by Poincaré plot has opened up ample opportunities for important clinical and research applications. Therefore, the present book can be used either for self-study, as a supplement to courses in linear and nonlinear systems, or as a modern monograph by researchers in this field of HRV analysis.
Heart rate variability (HRV) has become a popular method to study autonomic modulation of the cardiovascular system. Cardiovascular health depends on the proper functioning of several physiological systems, including the autonomic nervous system, which exerts its function via a complex interaction between its two branches: sympathetic and parasympathetic. Additionally, heart rate variability has been widely applied in basic and clinical research studies for describing the extent of sinus arrhythmia, and for assessing the function of cardiac autonomic regulation quantitatively. In other words, it is a mirror of the balance of sympathetic and vagal activity. This book discusses the prognostic significance, risk factors and clinical applications of heart rate variability.
How do you quantify the mental, physical, social, and cognitive health of people and organizations? Heart rate variability or HRV is the answer. HRV is a biometric that measures the differences in successive heartbeats. While simple, HRV provides an incredible amount of information on the health of our autonomic nervous system and brain. In recent years, HRV variability monitors have become smaller and very affordable. A simple smartphone application takes the data from the monitors, applies algorithms, and provides users with accurate data on their mental, physical, social, and cognitive health and wellness. Heart Rate Variability explores how professionals and organizations can implement HRV to track the psychological, social, and physical health of those they serve, their staff, and the organization. While those in any industry will benefit from this book, Healing with Heart Rate Variability contains chapters specific to organizations striving to integrate trauma-informed practices and research. HRV helps demonstrate the terrible impact of trauma. Without treatment and support, trauma devastates the brain and nervous system, making emotional regulation and insight difficult. More importantly, HRV tracks the trauma healing process or post-traumatic growth, building motivation as a person sees how their work and treatment are improving their health. HRV becomes a practical and powerful tool that, with proper implementation, helps change the lives of those struggling in our communities. HRV improves the efficiency and effectiveness of the work of professionals and organizations by providing them with daily feedback on the people they are striving to help. Even before achieving a tangible traditional outcome or reaching a goal, a person will see progress through improving HRV scores over time. This success builds motivation and confidence to take on bigger and bigger life challenges. A drop in HRV scores alerts the professional to provide support and reach out earlier than they might normally. The alert and early action that HRV allows can prevent one bad day from cycling into larger, more dangerous issues such as suicide, relapse, or harming another. Healing with Heart Rate Variability demonstrates how HRV will revolutionize how people and organizations approach self-care and staff wellness. The ability to create and maintain healthy working relationships with those in services is one of the most powerful predictors of successful outcomes. To accomplish this task for people with histories of abuse, neglect, and painful relationships takes a tremendous amount of compassion, empathy, and patience. While the work of helping others is gratifying, social workers, teachers, mental-health workers, physicians, nurses, and other helping professionals dominate the top occupations for burnout in our society. Daily HRV measurements provide insight and focus on self-care. Before HRV, burnout was a relatively subjective measure. HRV quantifies burnout and demonstrates how self-care strategies improve wellness and performance.Staff turnover and high levels of burnout make creating and maintaining a high-performing helping organization extremely difficult. HRV can provide organizations with a daily measure of the health and wellness of their staff, teams, and the entire organization. It provides a quantifiable answer to the question, "What is the organization's health today?" Getting HRV measures from staff allows managers to support staff self-care and determine the effectiveness of organizational initiatives to improve staff health and lower turnover.
New edition of the classic complete reference book for cardiologists and trainee cardiologists on the theory and practice of electrocardiography, one of the key modalities used for evaluating cardiology patients and deciding on appropriate management strategies.
Connecting Paradigms: A Trauma-Informed & Neurobiological Framework for Motivational Interviewing Implementation provides an innovative approach to helping those struggling with past trauma to make critical life changes and heal from their pain and suffering. Scientific understanding of the brain, the impact of trauma, and research around behavioral change has grown exponentially over the last several decades. This knowledge is challenging and transforming thinking around how we provide mental health and substance abuse education, medical care, criminal justice, and social work. Connecting Paradigms presents an integrated model combining research in neurobiology, trauma, behavioral change, harm reduction, and Motivational Interviewing into a practical skillset easily implemented across a variety of settings and professions.
Open a Window into the Autonomic Nervous SystemQuantifying the amount of autonomic nervous system activity in an individual patient can be extremely important, because it provides a gauge of disease severity in a large number of diseases. Heart rate variability (HRV) calculated from both short-term and longer-term electrocardiograms is an ideal win
This book introduces readers to the fundamental concepts of Heart Rate Variability (HRV) and its most important analysis algorithms using a hands-on approach based on the open-source RHRV software. HRV refers to the variation over time of the intervals between consecutive heartbeats. Despite its apparent simplicity, HRV is one of the most important markers of autonomic nervous system activity and it has been recognized as a useful predictor of several pathologies. The book discusses all the basic HRV topics, including the physiological contributions to HRV, clinical applications, HRV data acquisition, HRV data manipulation and HRV analysis using time-domain, frequency-domain, time-frequency, nonlinear and fractal techniques. Detailed examples based on real data sets are provided throughout the book to illustrate the algorithms and discuss the physiological implications of the results. Offering a comprehensive guide to analyzing beat information with RHRV, the book is intended for masters and Ph.D. students in various disciplines such as biomedical engineering, human and veterinary medicine, biology, and pharmacy, as well as researchers conducting heart rate variability analyses on both human and animal data. The second edition of the book has been updated to RHRV version 5.0. This version introduces a functionality to perform heart rate variability analysis on entire populations. This functionality automates and streamlines both the calculation of HRV indices in the time, frequency, and nonlinear domains, as well as the subsequent statistical analysis.
Up-to-date, authoritative and comprehensive, Heart Failure, 4th Edition, provides the clinically relevant information you need to effectively manage and treat patients with this complex cardiovascular problem. This fully revised companion to Braunwald's Heart Disease helps you make the most of new drug therapies such as angiotensin receptor neprilysin inhibitors (ARNIs), recently improved implantable devices, and innovative patient management strategies. Led by internationally recognized heart failure experts Dr. G. Michael Felker and Dr. Douglas Mann, this outstanding reference gives health care providers the knowledge to improve clinical outcomes in heart failure patients. - Focuses on a clinical approach to treating heart failure, resulting from a broad variety of cardiovascular problems. - Covers the most recent guidelines and protocols, including significant new updates to ACC, AHA, and HFSA guidelines. - Covers key topics such as biomarkers and precision medicine in heart failure and new data on angiotensin receptor neprilysin inhibitors (ARNIs). - Contains four new chapters: Natriuretic Peptides in Heart Failure; Amyloidosis as a Cause of Heart Failure; HIV and Heart Failure; and Neuromodulation in Heart Failure. - Covers the pathophysiological basis for the development and progression of heart failure. - Serves as a definitive resource to prepare for the ABIM's Heart Failure board exam. - 2016 British Medical Association Award: First Prize, Cardiology (3rd Edition).