HRV Monitoring and AFib

Is anyone using Heart Rate Variability (HRV) monitoring? Since endurance exercise was a meaningful contributor to my Afib, I'm wondering whether I could monitor my HRV to help me determine when I should back off in my workouts and when I might be able to go a little harder. I would be curious if anyone has any thoughts on whether this would be useful.

I'm also wondering whether AFib and/or ablations create distortions that render HRV less useful.

HRV is utterly meaningless during afib episodes because it can't be measured. I've read what little data there is on HRV as it relates to afib and although there are hints that a low HRV makes afib more likely, there's nothing convincing. I don't really see much use for it.

Thanks for the response, Carey. I was thinking more in terms of using it to monitor my autonomic "readiness" during periods when I'm in NSR. In this way I can avoid hard workouts when my nervous system is compromised (due to lack of sleep, stress, etc.) so as to reduce the risk of triggering an AFib episode.

Mike - another post by Dean .....[www.afibbers.org]
brings up the topic of HRV.

I had intended to respond with the following, but had a computer glitch and then didn't follow through later on......

Just FYI... My HRV evaluations were done both several years prior to and then after my second and third ablation, with the original in 2003.



Hi Dean… thanks for the reminder. It’s good to see this continuing validation.
You probably recall Hans’ report from some time ago… [www.afibbers.org]

The functional chiropractor I see for routine spinal alignment treatments, does a NeuroSpinal Function Index test periodically which includes the HRV assessment.

As a new patient in 2011, my score was 83. In 2015, I had two scans with scores of 98 and 97…so I was pleased with the improvement. These were after my ablations in 2014 and 2015.

A score of 80-89 is considered Good. A score of 95 to 100 is rated Excellent.

She gave me copies of these two reports on HRV

[www.preventionandhealing.com]

[level1diagnostics.com]


Jackie

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MikeShue
I was thinking more in terms of using it to monitor my autonomic "readiness" during periods when I'm in NSR. In this way I can avoid hard workouts when my nervous system is compromised (due to lack of sleep, stress, etc.) so as to reduce the risk of triggering an AFib episode.

Okay, that will be an interesting experiment. Please keep us updated on how it goes.

I've periodically experimented with monitoring HRV since the late 90s (before I developed afib) and I do notice some correlation with afib. Usually there's a lot of high frequencies in my heart rate both before and after afib. Visually, the graph of my heart rate variability is very jagged, rather than a smooth sinusoidal wave.

I've used HRV software for years, but mostly to capture the r to r durations from my chest strap and export them to my Polar software - where I can see PAC's & PVC's (and afib). More recently I started using the Elte HRV app. From their page:

"Our HRV score process is broken down as follows:

We capture the R-R intervals via the chest strap heart rate monitor.
We apply the RMSSD calculation. Root Mean Square of Successive Differences (RMSSD) is the industry standard, time domain measurement for detecting Autonomic Nervous System activity in short-term durations (5 minutes or less).
A natural log (ln) is applied to RMSSD. Since RMSSD behaves logarithmically, it is difficult to conceptualize the magnitude of changes as it rises and falls. Therefore, it is common practice in the application of RMSSD to apply a natural log to produce a number that behaves in a more linearly distributed fashion.
The ln(RMSSD) is expanded to generate a useful 0 to 100 score. The ln(RMSSD) value typically ranges from 0 to 6.5. Using over 1,000,000 readings from our database, we have been able to sift out anomalous readings and create a much more accurate scale where everyone fits in a 0 to 100 range."

In Elite HRV, the scoring is based on your history and large variations in their HRV metric from your baseline, low or high, are considered not good. Prior to this I was under the impression that larger was better (with the exception of afib...).

Hence it is one number, which is somewhat useable. My other app, Heart Rate Variability Logger, reports: "AVNN, SDNN, rMSSD, pNN50, LF, HF, LF/HF." All great stuff but a little hard to make sense of.

My afib is infrequent, so I have no correlation with episodes.

Yesterday I rock climbed for 6 hours at 7,500' elevation. This morning my HRV was a little lower than baseline, so I just did a walk in the park. My legs were a bit tired, so there was a correlation there.

As I write this, I recall that when I used to do high altitude races, after a race my resting HR could be elevated for a number of days. I'm guessing the HRV would have been low, then the resting HR would drop below my pre-race baseline, again for a number of days. Don't know what the HRV would have been during this time. Later, after I started having afib, the "resting HR lower than baseline" was a risk period for me, afib-wise.

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GeorgeN
As I write this, I recall that when I used to do high altitude races, after a race my resting HR could be elevated for a number of days. I'm guessing the HRV would have been low, then the resting HR would drop below my pre-race baseline, again for a number of days. Don't know what the HRV would have been during this time. Later, after I started having afib, the "resting HR lower than baseline" was a risk period for me, afib-wise.

This observation plus Dr. Peter Attia's discussion in the AMA #3 episode of his podcast called The Drive of how he uses HRV convinces me that there is some merit to the idea. I need to figure out the least intrusive way to measure my HRV and will report back when I have learned something.

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MikeShue
I need to figure out the least intrusive way to measure my HRV and will report back when I have learned something.

Chest strap and the Elite HRV app.

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Carey

I need to figure out the least intrusive way to measure my HRV and will report back when I have learned something.

Chest strap and the Elite HRV app.

I've found the Polar H10 heart rate sensor to have much fewer artifact problems than the H7.