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Heart Rate Variability

Impact on Heart Health

Why restore autonomic balance?

Increasing parasympathetic tone while reducing excessive sympathetic tone can be expected to slow heart rate, reduce blood pressure, provide a sense of well-being, and—based on preliminary clinical studies—provide an additional means of control over coronary plaque growth.
Nearly all people at the start display chaotic patterns of autonomic phenomena. If examined as variation in heart beat-to-beat cycles, patterns are disordered, following no particular rhyme or reason. At the extreme, beat-to-beat cycles show no variation, demonstrating perfect regularity of heart rhythm, a sign of very poor parasympathetic tone. Autonomic balance, whether achieved via prayer, meditation, deep diaphragmatic breathing, or various biofeedback techniques, is characterized by increased beat-to-beat variation. This is contrary to most people’s notion that perfect regularity in heart rate is desirable—it is not. Specifically, variation in heart beat is brought into phase with respiration. When heart beat variation is brought into phase with respiration, parasympathetic tone is heightened, sympathetic tone is subdued and autonomic balance is restored.
A state of autonomic balance is different from a state of relaxation, since relaxation is not necessarily associated with increased parasympathetic tone nor phasic cycling of heart rate and respiration. Relaxation is associated with reduced tone of muscles, clearing the mind of stressful thoughts, but is not necessarily coupled with improved autonomic balance.
What is HeartMath?

When you inhale, heart rate should increase; when you exhale, heart rate should decrease. These are normal physiologic responses to changes in blood volume returning to the right side of the heart: inhalation causes an increase in internal chest pressure (intrathoracic pressure), which causes resistance to blood return to the heart, which in turn leads to reflex increased heart rate; the rush of blood volume and drop in chest pressure with exhalation triggers the opposite. Even in the 10 seconds of a standard EKG recording, such variation from heart beat to heart beat can be seen (if present; it is often visibly absent).
Heart rate is therefore in synchrony with respiration. However, the degree of variation from beat to beat is governed by the balance of the sympathetic and parasympathetic nervous systems. In addition to the contribution of the respiratory cycle, the sympathetic nervous system causes acceleration of heart rate, i.e., shortening the time interval from beat-to-beat, while the parasympathetic nervous system slows heart rate, i.e., lengthens the time interval beat-to-beat.
Many situations are associated with increased sympathetic “tone” and thereby increased heart rate and decreased beat-to-beat variability. Chronic stress (increased adrenaline and cortisol), overweight, sleep deprivation, pre-diabetes and diabetes, coronary disease, and social detachment are among the situations associated with increased sympathetic tone and decreased beat-to-beat variability.
Increased parasympathetic tone, and thereby decreased heart rate and increased beat-to-beat variability, are accomplished with exercise, weight loss and achieving desirable weight, omega-3 fatty acid supplementation, adequate sleep, social relationships, and feelings of well-being.
In addition to the yin and yang of sympathetic and parasympathetic influences, negative emotional states and health conditions also disrupt the variation in heart rate, such that the inspiratory/expiratory cycle no longer determines heart rate or heart rate variability and no discernible pattern is evident. Chronic stress or frustration is an example: 

From HeartMath

While frustration is characterized by chaotic heart rate and heart rate variability, healthy parasympathetic-dominant heart rate variability while experiencing “appreciation” is represented on the bottom of the figure as a sine wave pattern, a smooth phasic variation in beat-to-beat variability in sync with respiration.
The state of bring heart rate variability in phase with respiration has been called “coherence” in the HeartMath program. Achieving coherence is therefore a goal of the program.
People who achieve high sustained levels of coherence report achieving a “zone” of feeling calm, being happy, at peace, an overall feeling of well-being. With consistent application, these feelings should extend into periods when you are not using the coherence tools, i.e., throughout other parts of your day. That is when genuine and substantial benefits develop.
Coherence tools for achieving healthy heart rate variability can be applied at will at any time. For instance, if facing a stressful situation, apply the coherence techniques to gain control over disruptive and counterproductive emotions and physiology. Apply them when you have difficulty falling asleep, when you’re struggling to clear unhappy thoughts from your mind, or during random free moments to restore healthy autonomic balance.  
Getting started with HeartMath

Once you’ve received your HeartMath device, loaded the software onto your computer, and plugged the heart rate monitor into a USB port and applied the earlobe heart rate monitor to your ear, you’re ready to go. The quickest way to get you up and running is to open up the HeartMath program on your computer and go to the Games area. Within Games, you will see a choice called Coherence Coach. This narrated program walks you through the technique, showing you how to use breathing and imagery to begin the process of regaining autonomic balance.
The basic steps you will be introduced to are:
Step 1 - Heart Focus

Focus on the area in the center of your chest, the area of your heart.
Step 2 - Heart Breathing

Focus on the area of your heart and pretend you are breathing through your heart. Pretend your breath is flowing in and out through that area. Breathe slowly and gently, in through your heart to a slow count of 5, pause at end-inspiration for a count of 2, then slowly and easily out through your heart for another slow count of 5 and pause again for another count of 2 at end-expiration: 5-2-5-2. Do this until your breathing feels smooth and balanced, not forced. As you continue to breathe with ease for a few moments, you will find a natural inner rhythm that feels good.
Step 3 - Heart Feeling

The third step involves positive feelings and attitudes. Continue to breathe through the area of your heart and find a positive feeling, like appreciation, care, or compassion. This could be the appreciation or care you have towards a special person, a place, or an event, even something as simple as a sunrise or the ocean.
Note that there are four levels of challenge, starting at low then up to medium, high and highest. Start with low. Once you consistently achieve a high level of coherence (e.g., 80-90% or greater), that’s a good time to move to the next challenge level. Progressing from level to level may require several weeks, even months, of consistent effort and practice. Don’t be discouraged when your coherence level appears reduced when you start a higher challenge level; consistent practice will yield greater coherence.
What will you have at the end of all this coherence-enhancing effort? Most people report an enhanced sense of well-being, along with reductions in blood pressure, and clarity of thinking. Many people report that they become more time-efficient, are able to focus more effectively, and are better able to filter out distractions. The stress hormone, cortisol, is reduced, while DHEA levels increase. Blood sugar control improves modestly, as evidenced by reductions in HbA1c.
The key is to practice achieving coherence often enough that you achieve what the HeartMath people call repatterning, the reprogramming of autonomic state that persists even when you are not actively engaged in obtaining coherence. Repatterning is evidenced by periods of spontaneous coherence that develop without conscious direction.
Curious phenomenon: The better you get at achieving rapid and deep coherence, the third step, “heart feeling,” i.e., visualizing or reliving happy or satisfying moments, will begin to come to you without conscious effort, sometimes flooding your consciousness with pleasant memories and emotions. This is when coherence begins to exert genuine positive changes in physiology. 
Additional resources:
“How to” and “Quick Coherence Tutorial” can be found under the book icon of the HeartMath software (upper right hand corner). These written instructions augment the narrated Coherence Coach.


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