Recognizing a Respiratory Sinus Arrhythmia

by Dr. Stephen Sinatra
Filed Under: Heart Health
Last Reviewed 03/28/2014

While most people aren’t familiar with the cardiology term heart rate variability, or respiratory sinus arrhythmia, it plays a big role in evaluating the heart and determining your risk for future cardiac events. 

Recognizing a Respiratory Sinus Arrhythmia As you probably know, your heart rate is not fixed. It fluctuates with physical activity and your emotions, as well as time of day, drugs, foods and food additives you may be exposed to, and even electropollution.  

In this way, your heart rate is dynamic. It speeds up when you exert yourself or become stressed, and slows back down with relaxation and sleep. That’s normal.

However, respiratory sinus arrhythmia is different.  It represents the subtle timing variations in your heart’s beat-to-beat intervals that occur with the simple process of breathing. The term “sinus arrhythmia” are often used to describe these slight fluctuations. The word arrhythmia is a bit of a misnomer here, because even though the heart rhythm isn’t precisely regular, that’s considered “normal.”   

Even though you can’t feel the difference, as you breathe, in your heart rate increases just ever so slightly, and when you breathe out, it decreases imperceptibly. We can see these fluctuations on an electrocardiogram.  

Monitoring Your Respiratory Sinus Arrhythmia

With the development of sophisticated computerized devices such as 24-hour Holter monitoring and other computer programs like the NerveExpress, reams of data on respiratory sinus arrhythmia have been collected.  Think of respiratory sinus arrhythmia as a window into how the autonomic nervous system—which controls physiological parameters like heart rate and blood pressure—communicates with the cardiovascular system. Truly fascinating stuff!

What’s been learned with all of this high-tech monitoring is that respiratory sinus arrhythmia represents an accurate assessment of your ability to cope with both internal and external environmental changes.  Decreased respiratory sinus arrhythmia—having too “fixed” a heart rate interval—is now regarded as the most accurate reflector of stress, and even a predictor of sudden cardiac death. 

In fact, altered respiratory sinus arrhythmia has been accepted as risk factor for sudden cardiac death that is independent of all the other usual American Heart Association heart risk factors, such as age, chronic hypertension, diabetes, smoking and so on. 

Electropollution and Respiratory Sinus Arrhythmia

A lot of people have poor respiratory sinus arrhythmia. Medications, such as alpha blocking drugs used to treat prostate disease, can decrease heart rate variability. More recently, we’ve learned that the overexposure to the electro-pollution of radio frequency from cell towers, cordless telephones and cell phones has the potential to reduce respiratory sinus arrhythmia, and that fact is finally getting more mainstream attention. In fact, I’ll be sharing the latest findings on that with you soon. 

Electromagnetic disturbances can also push those people vulnerable to low respiratory sinus arrhythmia to develop cardiac, arrhythmia, stroke and sudden cardiac death. Electro-sensitive adults and children report cardiac arrhythmias as one of many symptoms they experience with exposure to radio frequencies. 

People with low heart rate variability are often less able to “go with the flow” when faced with externals stressors, and more prone to stress-related disorders such as cardiovascular problems. 

While the news about respiratory sinus arrhythmia and vulnerability to heart disease and sudden cardiac death may sound alarming, the good news is that if you can INCREASE your respiratory sinus arrhythmia, you can reduce the likelihood of stress related disorders, including cardiovascular disease and sudden cardiac death. Stress management techniques that involve conscious breathing are helpful, including T’ai chi, yoga, Pilates, relaxation and imagery sessions.

Physical exercise is also good for respiratory sinus arrhythmia, as are meditation and grounding. As far as supplementation goes, my standard recommendation is a total daily dose of 1–2 grams of fish oil a day for healthy people, and 2–4 grams for individuals with heart disease, taken in two divided doses.

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