Respiratory sinus arrhythmia

ECG with respiratory sinus arrhythmia

The respiratory sinus arrhythmia ( RSA ), including respiratory arrhythmia called, often occurring mainly in adolescents synchronous with respiration variation describes the heart rate . The heart rate increases when you inhale and decreases again when you exhale.

Breathing rate and heart rate are distinct rhythms. They are related to each other and fluctuations occur in the process. RSA is a frequently investigated parameter or a characteristic property of the interaction between breathing and heart rate.

It was first described in 1860 by Petr Einbrodt (1835-1865).

term

Respiratio is the Latin term for breathing. In medicine, an arrhythmia denotes the irregularity, particularly with regard to the heart, the word component sinus indicates that the place of excitation is the sinus node of the heart. Unlike other arrhythmias in medicine, RSA is physiological. Which means that it has no disease value, but is the body's own specification of a healthy organism.

Measurement

Spectral analysis

The measurement of the respiratory sinus arrhythmia is an established standard method in autonomic functional diagnostics for checking the autonomic balance and the parasympathetic activity .

The influence of breathing on the heartbeat can either be done by measuring the pulse (with the help of pulse oximetry ) using a finger or ear clip, or an electrocardiogram . The resulting curves are mostly evaluated as a time series with the aid of computers . Since the respiratory sinus arrhythmia is a main component of the heart rate variability , there is approximately a sinusoidal coupling between breathing and heart rate.

A more specific measurement of the coupling of respiration and heartbeat can be shown for measurements longer than 3 minutes, for example by means of the spectral analysis . It is used to determine which frequency components, in addition to the respiratory sinus arrhythmia, make up the variability of the heart rate.

From a medical and scientific perspective, the quantity and quality of the respiratory sinus arrhythmia is described using the amplitude of the heart rate change within a representative breath of 6 successive breaths (EI difference, RSA).

physiology

The respiratory arrhythmia is a normal finding that occurs in children and adolescents. The RSA comes about through breath-dependent changes in the influence of the parasympathetic nervous system on the heart. When inhaling, the lungs expand, which inhibits vagal tone and thus increases the influence of the sympathetic system on the heart; the heart rate increases.

With increasing age, the ability to produce this flexible reaction of the heartbeat to the respective requirements decreases.

An excessively regular heart rate that shows no signs of respiratory sinus arrhythmia may indicate asphyxia in the newborn.

research

The cardiorespiratory interaction takes place u. a. Significance in infant research, as well as in the risk stratification of heart patients and diabetics.

Another study deals with the vegetative control of the heart rate and its coordination with the respiratory system while sleeping and waking.

literature

CM Brown et al .: A simple deep breathing test reveals altered cerebral autoregulation in type 2 diabetic patients . In: Diabetologia , 2008, 51 (5), pp. 756-761
Einbrodt: About the influence of breathing movement on heartbeat and blood pressure . In: Sber. Akad. Wiss. Vienna - Math. Nat. Kl., 2. Abt., 40, 1860, pp. 361-418 (cited for example in: Peter Aikele: Investigation of the development of cardiorespiratory interaction of common rhythms of breathing and heart action. (PDF) Dissertation 1998, Institute for Physiology / Humboldt University Berlin, p. 5)
A Katz et al .: A simple bedside test of 1 minute heart rate variability during deep breathing as aprognostic index after MI . In: Am Heart J , 1999, 138, pp. 32-38
Manfred Stöhr, M. Wagner, K. Pfadenhauer, K. Scheglmann: Neuromonitoring . Steinkopff Verlag, 1999, ISBN 3-7985-1160-8 (describes respiratory sinus arrhythmia on p. 123/124)
M Rosengard-Bärlund et al .: Early autonomic dysfunction in type 1 diabetes: a reversible disorder? In: Diabetologia , 2009, 52, pp. 1164-1172

Web links and further literature

Experimental electrocardiographic studies on the effect of respiration on cardiac activity . In: Pflügers Archiv - European Journal of Physiology , Volume 155, Number 8-9 / January 1914, doi: 10.1007 / BF01681163 , pp. 443-460.
P. Grossman, EW Taylor: Toward understanding respiratory sinus arrhythmia: Relations to cardiac vagal tone, evolution and biobehavioral functions . In: Biological Psychology Volume 74, Issue 2, February 2007, pp. 263-285
EA Butler, FH Wilhelm, JJ Gross: Respiratory sinus arrhythmia, emotion, and emotion regulation during social interaction . In: Psychophysiology , Volume 43, Number 6, November 2006, pp. 612-622.
D Loellgen et al .: The deep breathing test: median-based expiration-inspiration difference is the measure of choice . In: Muscle Nerve , 2009, 39 (4), pp. 536-544
Neff RA, Wang J, Baxi S, Evans C, Mendelowitz D: Respiratory sinus arrhythmia: endogenous activation of nicotinic receptors mediates respiratory modulation of brainstem cardioinhibitory parasympathetic neurons . In: Circ Res . . 93, No. 6, 2003, pp. 565-572. doi : 10.1161 / 01.RES.0000090361.45027.5B . PMID 12907666 .
S Duschk, M Muckenthaler, N Werner, GA del Paso: Relationships between features of autonomic cardiovascular control and cognitive performance . In: Biol Psychol. , 2009 May, 81 (2), pp. 110-117. Epub 2009 Mar 24, PMID 19428975 (RSA & cognitive attention)
CM Licht, EJ de Geus, R van Dyck, BW Penninx: Association between Anxiety Disorders and Heart Rate Variability in The Netherlands Study of Depression and Anxiety (NESDA) . In: Psychosom Med. , May 4, 2009, Epub ahead of print, PMID 19414616 (RSA & Ängste )

NM Bosch, e H Ries, J Ormel, F Verhulst, AJ Oldehinkel: Stressful life events and depressive symptoms in young adolescents: Modulation by respiratory sinus arrhythmia? The TRAILS study . In: Biol Psychol. , 2009 Apr, 81 (1), pp. 40-47. Epub Jan 31, 2009, PMID 19428967 (RSA and Depession)

TL Zucker, KW Samuelson, F Muench, MA Greenberg, RN Gevirtz: The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study . In: Appl Psychophysiol Biofeedback , June 2009, 34 (2), pp. 135-143, Epub 25 Apr 2009, PMID 19396540 (SRA and post- traumatic stress disorder)

Individual evidence

↑ Experimental electrocardiographic studies on the effect of respiration on heart activity . In: Pflügers Archiv - European Journal of Physiology , Volume 155, Number 8-9 / January 1914, doi: 10.1007 / BF01681163 , pp. 443-460.
↑ D Löllgen et al .: The deep breathing test: median-based expiration-inspiration difference is the measure of choice. Muscle nerves . 2009, 39 (4), pp. 536-544, PMID 19296458
^ Armin Kurtz, Hans-Christian Pape, Stefan Silbernagl (eds.): Physiology . 8th edition. Thieme, Stuttgart 2018, ISBN 978-3-13-242387-9 , p. 206 .
↑ WD Ekert, B. Kohler: Cardiorespiratory studies in cerebral disease . In: Monatsschr Kinderheilkd , 1974, 122, pp. 643-644
↑ Peter Aikele: Investigations on the development of cardiorespiratory interaction based on common rhythms of breathing and heart action. Longitudinal study of the first six months of life of healthy infants . Dissertation from the Institute for Physiology at the Humboldt University of Berlin Director PB Persson, submitted to the Medical Faculty of the Humboldt University of Berlin in 1997 to obtain the academic degree of doctor medicinae (Dr. med.)
^ A Katz et al .: A simple bedside test of 1 minute heart rate variability during deep breathing as aprognostic index after MI . In: Am Heart J , 1999, 138, pp. 32-38
↑ CM Brown et al .: A simple deep breathing test reveals altered cerebral autoregulation in type 2 diabetic patients . In: Diabetologia , 2008, 51 (5), pp. 756-761. M Rosengard-Bärlund et al .: Early autonomic dysfunction in type 1 diabetes: a reversible disorder? In: Diabetologia , 2009, 52, pp. 1164-1172
↑ Axel Unbehaun The vegetative control of the heart rate and its coordination with the respiratory system investigated during sleep and waking during puberty: a time series analytical study. Dissertation to obtain the academic degree of doctor medicinae (Dr. med.), From the Institute for Physiology of the Charité Medical Faculty of the Humboldt University of Berlin, 1998, on: Chapter 2. The question of the study: Time series analytical approaches as means, insights into to achieve the vegetative control of the heart and the cardiorespiratory interaction

[1] Experimental electrocardiographic studies on the effect of respiration on heart activity . In: Pflügers Archiv - European Journal of Physiology , Volume 155, Number 8-9 / January 1914, doi: 10.1007 / BF01681163 , pp. 443-460.

[2] D Löllgen et al .: The deep breathing test: median-based expiration-inspiration difference is the measure of choice. Muscle nerves . 2009, 39 (4), pp. 536-544, PMID 19296458

[3] Armin Kurtz, Hans-Christian Pape, Stefan Silbernagl (eds.): Physiology . 8th edition. Thieme, Stuttgart 2018, ISBN 978-3-13-242387-9 , p. 206 .

[4] WD Ekert, B. Kohler: Cardiorespiratory studies in cerebral disease . In: Monatsschr Kinderheilkd , 1974, 122, pp. 643-644

[5] Peter Aikele: Investigations on the development of cardiorespiratory interaction based on common rhythms of breathing and heart action. Longitudinal study of the first six months of life of healthy infants . Dissertation from the Institute for Physiology at the Humboldt University of Berlin Director PB Persson, submitted to the Medical Faculty of the Humboldt University of Berlin in 1997 to obtain the academic degree of doctor medicinae (Dr. med.)

[6] A Katz et al .: A simple bedside test of 1 minute heart rate variability during deep breathing as aprognostic index after MI . In: Am Heart J , 1999, 138, pp. 32-38

[7] CM Brown et al .: A simple deep breathing test reveals altered cerebral autoregulation in type 2 diabetic patients . In: Diabetologia , 2008, 51 (5), pp. 756-761. M Rosengard-Bärlund et al .: Early autonomic dysfunction in type 1 diabetes: a reversible disorder? In: Diabetologia , 2009, 52, pp. 1164-1172

[8] Axel Unbehaun The vegetative control of the heart rate and its coordination with the respiratory system investigated during sleep and waking during puberty: a time series analytical study. Dissertation to obtain the academic degree of doctor medicinae (Dr. med.), From the Institute for Physiology of the Charité Medical Faculty of the Humboldt University of Berlin, 1998, on: Chapter 2. The question of the study: Time series analytical approaches as means, insights into to achieve the vegetative control of the heart and the cardiorespiratory interaction