1st Edition

Heart Rate Variability (HRV) Signal Analysis Clinical Applications

Edited By Markad V. Kamath, Mari Watanabe, Adrian Upton Copyright 2013
    532 Pages 110 B/W Illustrations
    by CRC Press

    Open a Window into the Autonomic Nervous System

    Quantifying 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 window into such autonomic activity for two reasons: one, heart rate is sensitive to autonomic activity in the entire body, and two, recording electrocardiograms is inexpensive and non-invasive unlike other techniques currently available for autonomic assessment, such as microneurography and metaiodobenzylguanidine (MIBG) scanning. Heart Rate Variability (HRV) Signal Analysis: Clinical Applications provides a comprehensive review of three major aspects of HRV: mechanism, technique, and clinical applications.

    Learn Techniques for HRV Signal Analysis

    Edited by an engineer, a cardiologist, and a neurologist, and featuring contributions by widely published international researchers, this interdisciplinary book begins by reviewing the many signal processing techniques developed to extract autonomic activity information embedded in heart-rate records. The classical time and frequency domain measures, baroreceptor sensitivity, and newer non-linear measures of HRV are described with a fair amount of mathematical detail with the biomedical engineer and mathematically oriented physician in mind. The book also covers two recent HRV methods, heart-rate turbulence and phase-rectified signal averaging.

    Use of HRV in Clinical Care

    The large clinical section is a must-read for clinicians and engineers wishing to get an insight into how HRV is applied in medicine. Nineteen chapters altogether are devoted to uses of HRV in:

    • Monitoring—for example to predict potential complications in pregnancies, fetal distress, and in neonatal critical care
    • Acute care—for gauging the depth of anesthesia during surgery and predicting change in patient status in the intensive care unit
    • Chronic disorders—for assessing the severity of congestive heart failure, stroke, Parkinson’s disease, and depression

    Bringing together the latest research, this comprehensive reference demonstrates the utility and potential of HRV signal analysis in both the clinic and physiology laboratory.

    Heart Rate Variability: A Historical Perspective
    Markad V. Kamath, Mari A. Watanabe, and Adrian R.M. Upton

    Section I Heart Rate Variability Techniques

    Methodological Aspects of Heart Rate Variability Analysis
    Tom Kuusela

    Methodological Aspects of Baroreflex Sensitivity Analysis
    Tom Kuusela

    Arterial Blood Pressure Waveform Analysis and Its Applications in the Assessment of Vasovagal Syncope
    Juan Carlos Perfetto, Ricardo O. Sirne, Aurora Ruiz, and Carlos E. D’Attellis

    Heart Rate Turbulence
    Mari A. Watanabe and Georg Schmidt

    Phase-Rectified Signal Averaging: Methods and Clinical Applications
    Raphael Schneider, Alexander Müller, and Georg Schmidt

    Section II Clinical Applications of Heart Rate Variability—Monitoring

    Heart Rate Variability Analysis for the Monitoring of Fetal Distress and Neonatal Critical Care
    Manuela Ferrario, Federico Aletti, Giuseppe Baselli, Maria Gabriella Signorini, and Sergio Cerutti

    Heart Rate Variability and Blood Pressure Variability in Obstetrics and Gynecology
    Dietmar Schlembach and Manfred G. Moertl

    Effects of Exercise Training on Heart Rate Variability in Patients with Hypertension
    Philip J. Millar, Cheri L. McGowan, and Neil McCartney

    Heart Rate Variability and Sleep
    Eleonora Tobaldini, Krzystof Narkiewicz, Virend K. Somers, and Nicola Montano

    Section III Clinical Applications of Heart Rate Variability—Acute Care

    Heart Rate Variability in the Intensive Care Unit
    Mohammad Badrul Alam, Graham Jones, Andrew J.E. Seely, W.F.S. Poehlman, and Markad V. Kamath

    Heart Rate Variability and Cardiovascular Dynamic Changes during Local Anesthesia
    Panayiotis A. Kyriacou and Kamran Shafqat

    Effect of General Anesthesia on Heart Rate Variability
    Mathieu Jeanne, Régis Logier, and Benoît Tavernier

    Heart Rate Variability in Functional Neurosurgery
    Jonathan A. Hyam, Erlick A.C. Pereira, and Alexander L. Green

    Bariatric Surgery and Its Effects on Heart Rate Variability
    Anton F. Lodder, Markad V. Kamath, David Armstrong, and Adrian R.M. Upton

    Section IV Clinical Applications of Heart Rate Variability—Chronic Disorders

    Heart Rate Variability in Congestive Heart Failure
    Phyllis K. Stein and Yachuan Pu

    Heart Rate Variability Analysis in Ischemic Cardiomyopathy and Aortic Stenosis Patients
    José F. Valencia, Montserrat Vallverdú, Alberto Porta, Andreas Voss, Rafael Vázquez, and Pere Caminal

    Heart Rate Variability and Blood Pressure Variability in Respiratory Disease: Effects of Pharmaceutical Compounds, Non-Invasive Ventilation and Physical Exercise
    Audrey Borghi Silva and Aparecida Maria Catai

    Effects of Spinal Cord Injury on Heart Rate Variability and Blood Pressure Variability
    David S. Ditor, David Allison, and Markad V. Kamath

    Autonomic Dysfunction in Stroke
    Melanie I. Stuckey, Mikko Tulppo, and Robert J. Petrella

    The Significance of Heart Rate Variability in Patients with Epilepsy
    Manjari Tripathi and Navita Choudhary

    Classification of Parkinson’s Disease Severity Using Heart Rate Variability Analysis
    Che-Wei Lin, Jeen-Shing Wang, Pau-Choo Chung, Chung-Yao Hsu, Li-Ming Liou, Yen-Kuang Yang, and Ya-Ting Yang

    Heart Rate Variability in Neuropsychiatric Disorders
    Brook L. Henry

    Heart Rate Variability and Depression
    Gautam R. Ullal

    Heart Rate Variability as a Measure of Depression and Anxiety during Pregnancy
    Alison K. Shea, Meir Steiner, and Markad V. Kamath



    Markad V. Kamath, Ph.D. is a professor in the department of Medicine, with associate memberships in the Computing and Software Engineering and Electrical and Computer Engineering departments at McMaster University, Hamilton, Ontario, Canada. He received a B.Eng. from Karnataka Regional Engineering College (now the National Institute of Technology), India, a Ph.D. in biomedical engineering from the Indian Institute of Technology (Madras), and a Ph.D. in medical sciences from McMaster University. He is the editor of the journals Critical Reviews in Biomedical Engineering and Critical Reviews in Physical and Rehabilitation Medicine and the founding editor of Visualization, Image Processing and Computation in Biomedicine. He is a registered professional engineer in the province of Ontario, Canada.

    Mari A. Watanabe, M.D., Ph.D., is currently an assistant professor in the cardiology department at St. Louis University. She received her M.D. from Nippon Medical School in Tokyo and Ph.D. in physiology and applied mathematics from Cornell University. She has conducted research in cardiology, mathematics and physics at various institutions, including the University of Pennsylvania, Beth Israel Deaconess Medical Center in Boston, University of Utah, and Glasgow University in Scotland. She has received research grants from the American Heart Association, National Institute of Health and British Heart Foundation. She publishes papers in both clinical and basic science journals.

    Adrian R.M. Upton, M.D., FRCP(C), FRCP(E), FRCP(G), is a professor of medicine at McMaster University. Dr. Upton qualified as a physician in the United Kingdom and has held a number of senior positions, including the director of the neurology department and director of the Diagnostic Neurophysiology Laboratory at Chedoke-McMaster hospitals, Canada. He has published over 400 papers in areas such as autonomic stimulation, evoked potentials, electroencephalography and electromyography, among others. He has also trained many student physicians, residents, graduate students, and post-doctoral fellows. He holds 12 patents.