The RMSSD statistic, while useful for capturing high-frequency heart period fluctuations, is biased by basal heart period and passes lower frequency fluctuations, raising caveats for its interpretation as a pure index of vagal control.
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RMSSD warrants cautious clinical interpretation as a vagal index; leaves open questions on optimal HRV metrics for research.
Berntson et al. (2005) studied this question.
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