Influence of anxiety on the heart rate variability of patients in preoperative orthopedic surgery

Anxiety is a negative emotional response to situations that threaten the subject. Objective: The present study aims to verify the influence of anxiety on heart rate variability, considering two specific times: hospitalization and before surgery. In this analytical and cross-sectional study, the Hospital Anxiety and Depression Scale (HADS) was used to classify anxiety levels. Methodology: The time series of RR intervals were collected by Polar® monitor. Nonlinear methods and decision tree algorithm were combined with HADS scale to analyze the influence of the preoperative period on heart rate variability. The nonlinear methods used detrended fluctuation analysis (DFA), recurrence quantification analysis (RQA), and central tendency measure (CTM). Results: Among the 42 study participants, 13 (31%) were classified as anxious at hospital admission. The applied time domain methods found an increase in the heart rate variability (HRV) values in all features analyzed (p < 0.05). CTM method showed HRV reduction for the values considering radius between 6 and 20 milliseconds (p < 0.05). Conclusion: The anxiety identified at admission is directly related to the reduction in heart rate variability demonstrated by nonlinear methods, such as the central tendency measure.