Rehabilitation after myocardial infarction by using of biofeedback training, controlled by capnometry

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
I Yarmosh ◽  
S Boldueva ◽  
N Suvorov ◽  
T Sergeev

Abstract Funding Acknowledgements Type of funding sources: None. The increasing activity of the sympathetic nervous system was shown during myocardial infarction (MI). There are data that bio management application increases the vagal influences on a heart rate for patients with chronic coronary artery disease.  The purpose of this study was the assessment of changes of vegetative regulation of heart rate in patients with MI, receiving along with standard methods of treatment and rehabilitation sessions of cardiorespiratory training (KRT).  48 patients with IM in an early period of disease at the age from 40 till 70 years were surveyed. The main group was created from 29 people by whom KRT (5–10 sessions) was carried out. The assessment of efficiency and safety of KRT was carried out on a clinical picture and parameters of heart rate variability (HRV) before, after, and during KRT. The Control group consisted of 19 patients receiving only standard treatment. To exclude hyperventilation syndrome, capnometry was performed before the start of the KRT session to determine the FetCO2 individual norm for the certain patient to control the training process in a particular session. After each active sample, the concentration of carbon dioxide in the air exhaled by the patient was measured, and when it decreased below 95% of the initial value, the depth of breathing was adjusted. The use of capnometry in the study avoided adverse events during the sessions.  During carrying out of KRT, and after KRT worsening of the clinical picture at patients of the main group was not observed. HRV analysis at patients of the main group showed that after the end of KRT decrease in an index of tension (p < 0,05), an increase in an indicator of the general dispersion of heart rate (p < 0,05), and also a tendency to increase of vagal part of total power during spectral analysis (р=0,05) was observed. Normalization of heart rate and arterial pressure, growth of cardiorespiratory index, and index of a variation took place, cardiorespiratory synchronization was restored. Persons from the control group had no such changes.  Thus, the application of KRT realizing a mode of functional bio management of heart rate, as the instrument of psychophysiological support of standard medicament therapy showed the efficiency of its use in the program of rehabilitation of patients with myocardial infarction. The result of a comprehensive approach is the reduction of sympathetic and increase of vagal influences on heart rate, normalization of the main indicators of the cardiovascular system.

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
I Yarmosh ◽  
S Boldueva ◽  
N Suvorov ◽  
T Sergeev

Abstract Funding Acknowledgements Type of funding sources: None. The increasing activity of the sympathetic nervous system was shown during myocardial infarction (MI). There are data that bio management application increases the vagal influences on a heart rate for patients with chronic coronary artery disease.  The purpose of this study was the assessment of changes of vegetative regulation of heart rate in patients with MI, receiving along with standard methods of treatment and rehabilitation sessions of cardiorespiratory training (KRT).  48 patients with IM in an early period of disease at the age from 40 till 70 years were surveyed. The main group was created from 29 people by whom KRT (5–10 sessions) was carried out. The assessment of efficiency and safety of KRT was carried out on a clinical picture and parameters of heart rate variability (HRV) before, after, and during KRT. The Control group consisted of 19 patients receiving only standard treatment. To exclude hyperventilation syndrome, capnometry was performed before the start of the KRT session to determine the FetCO2 individual norm for the certain patient to control the training process in a particular session. After each active sample, the concentration of carbon dioxide in the air exhaled by the patient was measured, and when it decreased below 95% of the initial value, the depth of breathing was adjusted. The use of capnometry in the study avoided adverse events during the sessions.  During carrying out of KRT, and after KRT worsening of the clinical picture at patients of the main group was not observed. HRV analysis at patients of the main group showed that after the end of KRT decrease in an index of tension (p < 0,05), an increase in an indicator of the general dispersion of heart rate (p < 0,05), and also a tendency to increase of vagal part of total power during spectral analysis (р=0,05) was observed. Normalization of heart rate and arterial pressure, growth of cardiorespiratory index, and index of a variation took place, cardiorespiratory synchronization was restored. Persons from the control group had no such changes.  Thus, the application of KRT realizing a mode of functional bio management of heart rate, as the instrument of psychophysiological support of standard medicament therapy showed the efficiency of its use in the program of rehabilitation of patients with myocardial infarction. The result of a comprehensive approach is the reduction of sympathetic and increase of vagal influences on heart rate, normalization of the main indicators of the cardiovascular system.


2019 ◽  
Vol 18 (3) ◽  
pp. 167-174
Author(s):  
Liliya V. Poskotinova ◽  
Olga V. Krivonogova ◽  
Oleg S. Zaborsky

Background. Cardiovascular system recovery after physical activity with explosive exercises is essential for cardiovascular pathology prevention. The efficiency of short-term biofeedback training (BFB training) in such conditions in adolescents have not been studied earlier. Objective. Our aim was to study the effect of BFB training on cardiovascular rehabilitation after speed and power training in adolescents according to general heart rate variability (HRV) spectrum total power parameter. Methods. The research has included healthy eighth-grade students (14–15 years old boys) from regular school. Inclusion in experimental and control groups was regulated by researches. Such indicators as total power (TP) of HRV spectrum, tension index (TI), systolic and diastolic arterial blood pressure (ABP), heart rate (HR) were registered initially, after three standing long jumps with double take-off and after recovery. All members of experimental group performed BFB training in order to increase TP (3 min) during recovery period. Members of control group were resting. Results. Initially all members of experimental (n = 17) and control (n = 10) groups were compared on age, height, weight and TP, TI, ABP and HR indicators. The TP level in boys of experimental group was higher than in control group during recovery period after BFB training: 3.22 (1.96; 6.13) against 1.36 (1.15; 1.84) X 1000 ms2 respectively (р = 0.041). There were no differences in TI, ABP and HR levels between two groups during recovery period. Conclusion. Implementation of short-term BFB training according to general HRV spectrum total power parameter in 14–15 years old boys after speed and power training perpetuates vagal impact on heart rate during recovery period.


Author(s):  
M.M. Nekrasova ◽  
◽  
I.V. Fedotova ◽  
S.A. Polevaya ◽  

Abstract: Introduction. Increasing information loads can lead to the development of professional stress and work-related illnesses in knowledge workers. The development and implementation of modern methods of control and correction of the functional state of employees in the conditions of activity is relevant. The study aims – to explore the dynamics of the functional state of knowledge workers in the conditions of modeling the cognitive load on the computer and during the training on neurofeedback (NFB) based on the parameters of the electroencephalogram (EEG). Materials and methods. 17 researchers (4 men and 13 women aged 22-63 years (34.8±3.4), with an average work experience of 12.1±3.3 years) participated in the study on the basis of voluntary informed consent. Results. A significant increase in the index of the alpha rhythm was shown by 29.4% of the subjects. It was found that the total power of the spectrum of heart rate variability (HRV) is higher, the adaptive risk is lower in the group that successfully passed alpha training (p<0.05). According to the results of continuous personalized heart rate telemetry, the dynamics of the functional state (FS) during the examination was determined for each subject. Conclusion. A significant influence of the state of neurohumoral regulation systems and adaptive reserves of the body on the success of the biofeedback training was established, which is the basis for the development of methodological approaches to the correction of FS, taking into account individual optimal management strategies.


2021 ◽  
Vol 23 (6) ◽  
pp. 766-771
Author(s):  
T. O. Kulynych ◽  
O. O. Lisova ◽  
O. V. Shershnova ◽  
A. V. Hrytsai

Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic coronary syndrome (CCS) and community-acquired pneumonia (CAP), and to define their relationship with the clinical features of the disease. Materials and methods. A monocenter cross-sectional study analyzed 90 patients with CCS in parallel groups. The main group included 60 CCS patients with CAP; the control group consisted of 30 patients without concomitant CAP. A complex clinical examination of patients was performed on 1–3 days of hospital stay in accordance with the National Recommendations. Holter ECG monitoring was performed using a CARDIOSENS K device (XAI-MEDICA, Ukraine). Results. Based on the results of 24-hour ECG monitoring, heart rhythm disorders, increased duration of myocardial ischemia and ST-segment depression depth with an increase in the total duration of tachycardia episodes within 24 hours were more common in the main group patients. The severity of CAP on the PSI/PORT scale was correlated with the 24-hour mean heart rate (r = +0.31, P < 0.05), the number of ventricular extrasystoles – with respiratory rate (r = +0.29, P < 0.05), supraventricular extrasystoles – with the duration of ST-segment depression (r = +0.57, P < 0.05). In patients with CCS and CAP, there was a decrease in the total heart rate variability (HRV), mainly in the passive period, combined with an increase in the LF/HF ratio and stress index (SI), which was directly correlated with the severity of CAP and intoxication syndrome. Conclusions. Patients with CCS and CAP are characterized by the increased 24-hour heart rate, duration of ST-segment depression, frequency of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring, paroxysms of atrial fibrillation with the decreased total HRV combined with significantly increased activity of the sympathetic autonomic nervous system.


2016 ◽  
pp. 67-74
Author(s):  
Maryna Dolzhenko ◽  
Olena Popovich ◽  
Oksana Shershnyova ◽  
Oleksandr Nudchenko ◽  
Kardo Faradzh ◽  
...  

The objective: to evaluate the efficiency of ethylmethylhydroxypyridine (Mexiprim, STADA Arzneimittel AG, Germany) in patients presenting with myocardial infarction at hospital and outpatient stage. Patients and methods. The study included 59 patients with coronary artery disease, acute coronary syndrome with ST1segment elevation in the first day of admission to the ICU, AH, 3-stage, 2 degrees, HF. To all patients basic therapy according to current ESH/ESC guidelines was prescribed. To 39 patients additionally intravenous infusion of 200 mg of mexiprim o.d. for 10 days, followed by 125 mg per os three times a day for next 60 days was administered. Another 20 patients presented control group and received only basic therapy. The study design included: 24-hour Holter monitoring to estimate the dynamics of changes in the ST segment, cardiac arrhythmias and heart rate variability, evaluation by the scale of Beck, Hamilton scale for the assessment of anxiety (HARS) and depression (HDRS), the common blood and urine tests, biochemical blood analysis, evaluation of therapeutic tolerability conducted before treatment and 60 days after treatment. Surveys on a scale SAN, assessment of cognitive impairment on the MMSE scale were performed on the 60th day of treatment. Efficiency criteria were: a 50% reduction of cardiac arrhythmias, a decrease in ischemia, a decrease by 50% or more from baseline average score by HARS, HDRS scales, dynamics of the mental state questionnaire and less than 9 points on a scale of depression, reducing in SAN scale score. Results. In pаtients of mexiprim group significant reduction of depression scores by 62% were observed. According to the dynamics of the mental state questionnaire patients of mexiprim group reported feeling better, that is, reduction of score by 45% . According to the Hamilton scale for the assessment of anxiety (HARS), in particular mental anxiety – decrease in the total score of 65%, somatic anxiety – by 35.5%, and a total of 50% were revealed. In the group of patients receiving additionally intravenous Mexiprim for 10 days significantly reduced the number of single and group PACs, as well as single and multiple PVCs, not only in comparison with these parameters before the treatment, but also in comparison with the control group. In patients treated with Mexiprim no evidence of residual ischaemia were noted, but in the control group statistically significant segment depression ST remained. Heart rate variability was not significantly changed in the control group, but increased in patients who received Mexiprim. Conclusion. Use of Mexiprim in patients with myocardial infarction reduces ST segment depression, amount of ventricular and supraventricular arrhythmias, improved heart rate variability, and the state of anxiety and depression.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Chumachenko ◽  
E.D Kosmacheva

Abstract Background and introduction Metabolic syndrome (MS) is a baseline condition that influencesthe management of patients with coronary heart disease (CHD). The assessment of genotyping characteristics in patients with MS with non-ST segment elevation myocardial infarction (nSTEMI) remains a challenge. Purpose To define characteristics of G Protein β3 subunit gene C825T polymorphism; T786C in the eNOS gene and G894T in the eNOS gene in patients with MS after nSTEMI, evaluate the prognostic specificity of genotypes in a study population. Methods The study included 150 patients with CHD and MS. The main group included 99 patients (69.7% males, a mean age of (67.4±0.7 y))with nSTEMI, preserved left ventricular systolic function who underwent urgent percutaneous coronary intervention. The control group included 51 patients with a mean age of (64.6±1.3 y) without the history of previous myocardial infarction and acute cerebrovascular disease. There was no statistically significant difference between gender and age in two groups (p&gt;0.05). The predictive significance of the main group genotypes was estimated with odds ratio and risk ratio of “cumulative point of undesirable effects” (CPUE) and included: cardiovascular death, acute coronary syndrome, repeat revascularization, hospitalization for congestive heart failure. The accuracy of the genotype distribution corresponded to the Hardy-Weinberg equilibrium (p&gt;0.05). The accuracy of the results was analyzed using Student, χ2, Fisher's criteria. Results We received high patient numbers with CC genotype of eNOS:786 gene in the main group (n=19 (19.2%)) as compared with the controls (n=3 (6.2%)) (p&lt;0.05, φ=0.03), with GG genotype of eNOS:894 (p&lt;0.01, χ2=8.0) in the main group (n=59 (59.6%)) as compared with the controls (n=18 (35.3%)), with CC genotype of eNOS:894 in the control group (n=40 (78.4%)) as compared with the main group (n=56 (56.6%)) (p&lt;0.05; χ2=7.0). Patients who were heterozygous for eNOS:894 gene prevailed in the main group (n=30 (30.3%)) as compared with the controls (n=27 (52.9%)) (p&lt;0.01, χ2=7.3). The statistically significant CPUE was more frequent diagnosed in patients with TT genotype of GNβ3:825 (OR=12.00, 95% confidence interval ((CI): 2.8–51.7, p&lt;0.05), CC genotype of eNOS:786 (OR=5.1, 95% CI: 1.3–20.0, p&lt;0.05) and TT genotype of eNOS:894 (OR=8.0, 95% CI: 1.8–35.2, p&lt;0,05). Conclusions 4 practically applicable categories of reviewed genotypes were found: 1) nSTEMI - -protective: CC genotype for GNβ3:825 gene, GT – eNOS:894, 2) nSTEMI – unfavorable: CT–GNβ3:825, CC – eNOS:786 and GG – eNOS:894, 3) CPUE – unfavorable: TT – GNβ3:825, CC – eNOS:786, TT – eNOS:894, and 4) nSTEMI, CPUE-neutral: TT and TC – eNOs:786. CC – eNOS:786 genotype is separated as unfavorable for the development of both nSTEMI and CPUE. More studies are necessary for a personified approach, taken into account the obtained features of genetic associations. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Scientific Research Institute - S.V. Ochapovsky Clinic Regional Hospital #1, Krasnodar


2017 ◽  
Vol 04 (02) ◽  
pp. 108-113
Author(s):  
Mohit Mittal ◽  
Radhakrishnan Muthuchellappan ◽  
G. Umamaheswara Rao ◽  
K. Kavyashree ◽  
K. Vishnuprasad

Abstract Background: Impaired autonomic function (AF) can result in adverse cardiovascular events during the perioperative period. Literature suggests that patients with intracranial space-occupying lesions experience impaired AF depending on the site of tumour and associated raised intracranial pressure (ICP). The complex interaction between general anaesthetics, AF and intracranial tumours with raised ICP has not been extensively studied. Objective: This study was aimed at evaluating the cardiac AF (in terms of heart rate variability [HRV]) in patients undergoing surgery for supratentorial tumours, at baseline and at different propofol effect site concentrations (Ce) during anaesthetic induction and the results were compared with patients undergoing non-cranial surgeries. Materials and Methods: In this prospective observational study, consecutive adult patients undergoing surgeries for supratentorial tumour (study group) and brachial plexus injury (control group) were recruited. Electrocardiogram was recorded for 5 min at three time points – before propofol induction, at propofol Ce 2 μg/ml and at Ce 4 μg/ml. Results: Forty-five patients were recruited, 24 in study group and 21 in control group. In spite of similar baseline heart rate and blood pressure, low frequency (LF), high frequency (HF) and total power were significantly higher in control group. Baseline LF/HF, though higher in patients with intracranial tumour (craniotomy: 2.2 ± 2.2, control: 1.2 ± 1.1), was not significantly different between the two groups (P = 0.197). HRV variables in both the groups changed the same way in response to the increasing propofol Ce. Conclusion: HRV measurements were significantly different at baseline between the two groups. Following propofol administration, haemodynamic changes and HRV changes were similar in both the groups and also between the two groups.


2016 ◽  
Vol 97 (2) ◽  
pp. 177-181
Author(s):  
A N Osmolovsky ◽  
L V Babenkova

Aim. To assess the effectiveness of the original puncture transvenous temporary endocardial springy electrode use in patients with myocardial infarction complicated by bradyarrhythmias.Methods. The study included 126 patients with myocardial infarction complicated by acute bradyarrhythmias. The original endocardial electrode was used in 38 patients (main group). Temporary artificial heart rhythm control was performed using endocardial springy temporary puncture electrode in 88 cases of bradyarrhythmias (control group). Written informed consent was taken from all patients who underwent the procedure, and in the absence of contact with the patient decision to perform temporary cardiac pacing was made by a council of physicians.Results.. Spontaneous pacing interruption occurred in 13 patients of the main group and 32 control group patients at various times of the artificial pacing. Thanks to the used original electrode constructional features, fatal cases were prevented in 11 (84.6%) patients of the main group. In 9 of 32 patients of the control group with impaired pacemaker, cardiac pacing was restored by the electrode re-fixation to the heart right ventricular endocardium. In 23 patients of the control group artificial rhythm was restored by the method of endocardial electrode reposition. The number of patients with a spontaneous interruption of temporary artificial heart rhythm control had a strong correlation with the number of patients with the identified new changes in the electrocardiogram (ST segment elevation with acute recurrent myocardial infarction; r=0.84, pConclusion. In case of spontaneous interruption of temporary cardiac pacing caused by the loss of myocardial electrical conduction function in the area of the contact with the electrode, for effective and safe fatal cases prevention endocardial electrodes of the original design use is recommended.


Author(s):  
V. H. Korniienko ◽  
A. S. Fitkalo

According to modern data, the cardiovascular system is a kind of indicator of the organism's adaptive activity, and the structure of the heart rhythm carries information about the development of adaptive reactions in response to irritating factors of the external and internal environment.The aim of the study – to investigate the functional state of the autonomic nervous system in pregnant women who have harmful habits by evaluating and analyzing the parameters of heart rate variability in order to prevent complications of non-delivery of gestational process.Materials and Methods. The study involved 73 pregnant women, 53 of them were pregnant (the main group) who had malignant habits in history. Before studying adaptive reactions in pregnant women, a study of cardiac rhythm variability was performed in practically healthy non-pregnant women of reproductive age (25.3±2.2) years). The control group consisted of 20 pregnant women without any harmful habits. Determination of heart rate variability was performed on the basis of peripheral heart rate recording, which included measuring the sequence of RR intervals for 5 minutes, followed by mathematical analysis using the PlsMntr software product.Results and Discussion. It was established that in the main group, in the complicated failure to pass the gestational process, violations of cardiac rhythm variability were detected in 59.7 % of cases. There is an increase in the frequency of very low frequency (VL F) waves (43.5 % relative to control, p<0.05), indicating a predominance of humoral and metabolic rate of regulation of the cardiac rhythm. At the threat of premature births, a decrease in the particle (LF) is observed at 36.6 %, a decrease in the share of high-frequency waves (НF) by 30.8 %. Taking into account the results of the study, one can speak of a decrease in the tone of the sympathetic and parasympathetic nervous system, reducing the influence of the reflexive vegetative level of regulation, which, in turn, indicates the depletion of regulatory mechanisms and the lack of an adaptive protective effect of n.vagus on the heart.Conclusions. Our innovative low-invasive method of evaluating the adaptive reactions of the organism through the determination and analysis of indicators of cardiac rhythm variability in pregnant women with the existing harmful habits offers us the opportunity to observe manifestations of functional stress of regulatory systems of pregnant women, preceding the development of complication of non-delivery of gestational process.


2021 ◽  
Vol 5 ◽  
pp. 205970022110464
Author(s):  
Marquise M Bonn ◽  
Liliana Alvarez ◽  
Laura Graham ◽  
James W Thompson ◽  
James P Dickey

Background Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible. Purpose To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms. Methods Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the intervention group completed three 20 min low-resolution electromagnetic tomography neurofeedback sessions per week and at-home heart rate variability biofeedback training every morning and night for 8 weeks. Feasibility was evaluated according to recruitment capability and sample characteristics, data collection procedures, suitability of the intervention and study procedures, management and implementation of the study intervention, and preliminary participant responses to the intervention. Results Thirty-three individuals were recruited and 24 completed this study (seven intervention participants, nine persistent post-concussive symptoms control participants, and eight healthy control participants). One-quarter of participants (four intervention participants and three persistent post-concussive symptoms control participants) experienced simulator sickness during the driving simulator task and had to withdraw from the study. Intervention participants had an 88% and 86% compliance rate for the low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback sessions, respectively. Low-resolution electromagnetic tomography neurofeedback sessions took approximately 1 h to complete per participant. Preliminary analysis indicated that the intervention reduced electroencephalograph z-score deviation with a very large effect size ( d = 1.36) compared to the other study groups. Conclusions Pilot studies evaluating the efficacy of low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback should be performed to confirm these preliminary findings. However, the protocol should be modified to reduce participant fatigue and withdrawal. This trial was registered with Clinicialtrials.gov (NCT03338036; https://clinicaltrials.gov/ct2/show/NCT03338036?term=03338036&draw=2&rank=1 ).


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