Key result
HRV-biofeedback increases HRV by ~6 ms and reduces panic symptoms versus sham in panic disorder.
Why the study?
Some individuals with panic disorder display reduced HRV, which may increase cardiovascular mortality risk, but the effect of HRV-biofeedback training in this population required investigation.
Does HRV-biofeedback improve heart rate variability and reduce panic symptoms in individuals with panic disorder?
RCT (n=52)
randomly allocated
Does HRV-biofeedback improve heart rate variability and reduce panic symptoms in individuals with panic disorder?
A 4-week HRV-biofeedback intervention improves autonomic modulation and reduces panic symptoms in individuals with panic disorder.
Answers are grounded in this paper and cite their sources.
Supports adjunctive HRV-biofeedback in panic disorder; extends biofeedback evidence to autonomic and symptom outcomes in RCT.
OBJECTIVE: Some individuals with panic disorder (PD) display reduced heart rate variability (HRV), which may result in an increased risk of cardiovascular mortality. Heart rate variability-biofeedback (HRV-BF) training has been shown to improve the modulation of the autonomic activity. Therefore, this randomized controlled trial was conducted to investigate the effect of a 4-week HRV-BF intervention in individuals with PD. HRV-BF training improved the modulation of the autonomic activity. Therefore, with this randomized controlled trial, we aimed to investigate the effect of a 4-week HRV-BF intervention in people with PD. METHODS: Thirty-six women and 16 men with PD (mean age = 35.85 [15.60] years) were randomly allocated either to HRV-BF with 0.1-Hz breathing as intervention group or to HRV-Sham-BF as active control group. HRV-BF was performed for 4 weeks, whereas HRV was measured both during a short-term resting condition and during a paced breathing condition before and after intervention. RESULTS: HRV-BF with 0.1-Hz breathing increased HRV and reduced panic symptoms in individuals with PD. HRV-BF with 0.1-Hz breathing demonstrated an increase in the time and frequency domain parameters of HRV during the short-term resting condition (ΔPost-Pre root mean square successive differences: 5.87 [14.03] milliseconds; ΔPost-Pre standard deviation of all NN intervals: 11.63 [17.06] milliseconds; ΔPost-Pre total power: 464.88 [1825.47] milliseconds2; ΔPost-Pre power in low-frequency range 0.04-0.15 Hz: 312.73 [592.71] milliseconds2), a decrease in the heart rate during the paced breathing condition (ΔPost-Pre: -5.87 [9.14] beats/min), and a decrease in the Panic and Agoraphobia Scale (ΔPost-Pre: -3.64 [6.30]). There was no intervention effect in the HRV-Sham-BF group. CONCLUSIONS: HRV-BF as a noninvasive and nonpharmacological treatment seems to be an important intervention option to improve reduced HRV and decrease panic symptoms in individuals with PD. Future studies are needed to establish whether these effects translate to reductions in the risk of cardiovascular disease in PD.
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Herhaus et al. (2021) conducted an RCT in Panic disorder (n=52). Heart rate variability-biofeedback (HRV-BF) vs. HRV-Sham-BF was evaluated on Heart rate variability (HRV) and panic symptoms. A 4-week HRV-biofeedback intervention increased HRV (RMSSD increased by 5.87 ms) and reduced panic symptoms (Panic and Agoraphobia Scale decreased by 3.64) compared to sham in panic disorder.
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