Abstract
The autonomic nervous system (ANS) is critically important in both physiological and psychological health and well-being. However, the noninvasive assessment of the ANS is not trivial and requires special care. The advent of modern, turnkey systems for the measurement of impedance cardiography and heart rate variability (HRV) has greatly enhanced our ability to capture indices of ANS function but has also opened the field up to less than fully informed use of these measures. It is now currently possible to measure both central and peripheral cardiovascular functions in an ambulatory setting. This has expanded the opportunities as well as the challenges associated with ANS measurement. The present chapter seeks to briefly summarize major aspects of the assessment of ANS function using impedance cardiography and HRV. We start with an overview of the ANS and one of its most important aspects, the baroreflex. We then describe the use of impedance cardiography with special care taken to highlight important findings since the publication of the Society for Psychophysiological Research guidelines. We next describe the assessment of HRV and again hope to highlight important research since the publication of several seminal guideline papers. It is hoped that this chapter will provide a ready resource for researchers and others interested in the noninvasive assessment of the autonomic nervous system in health and disease.
Note: This is an updated and expanded version of a previous chapter by Thayer J. F., Hansen, A. L., & Johnsen, B. H. (2010). The non-invasive assessment of autonomic influences on the heart using impedance cardiography and heart rate variability. In A. Steptoe (Ed.), Handbook of behavioral medicine: methods and applications. Springer
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Ahern GL, Sollers JJ, Lane RD, Labiner DM, Herring AM, Weinand ME, Hutzler R, Thayer JF (2001) Heart rate and heart rate variability changes in the intracarotid sodium amobarbital test. Epilepsia 42(7):912–921
Allen JJB, Chambers AS, Towers DN (2007) The many metrics of cardiac chronotropy: a pragmatic primer and a brief comparison of metrics. Biol Psychol 74(2):243–262
Amerena J, Julius S (1995) Role of the nervous system in human hypertension. In: Hypertension: mechanisms and therapy. Current Medicine, Philadelphia
Appelhans BM, Luecken LJ (2006) Heart rate variability as an index of regulated emotional responding. Rev Gen Psychol 10(3):229
Arnett DK, Devereux RB, Kitzman D, Oberman A, Hopkins P, Atwood L, Dewan A, Rao D (2001) Linkage of left ventricular contractility to chromosome 11 in humans. The HyperGEN Study. Hypertension 38(4):767–772
Arnsten AFT, Goldman-Rakic PS (1998) Noise stress impairs prefrontal cortical cognitive function in monkeys: evidence for a hyperdopaminergic mechanism. Arch Gen Psychiatry 55(4):362
Benarroch E (1993) The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc 68:988–1001
Benarroch EE (1997) Central autonomic network. Futura Publishing Company
Benarroch EE (2008) The arterial baroreflex. Neurology 71(21):1733
Berne RM, Levy MN (2001) Cardiovascular physiology. Mosby Press, London
Berntson GG (1997) Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology 34(6):623–648
Bigger JT Jr, Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN (1992) Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation 85(1):164
Bogert LWJ, Van Lieshout JJ (2005) Non invasive pulsatile arterial pressure and stroke volume changes from the human finger. Exp Physiol 90(4):437–446
Boomsma D, Van Baal G, Orlebeke J (1990) Genetic influences on respiratory sinus arrhythmia across different task conditions. Acta Genet Med Gemellol 39:181–191
Brook RD, Julius S (2000) Autonomic imbalance, hypertension, and cardiovascular risk. Am J Hypertens 13:112S–122S
Bruehl S, Chung OY (2004) Interactions between the cardiovascular and pain regulatory systems: an updated review of mechanisms and possible alterations in chronic pain. Neurosci Biobehav Rev 28(4):395–414
Busjahn A, Voss M (1998) Angiotensin-converting enzyme and angiotensinogen gene polymorphisms and heart rate variability in twins. Am J Cardiol 81(6):755–760
Coleman WM (1920) On the correlation of the rate of heart beat, breathing, bodily movement and sensory stimuli. J Physiol 54(4):213
Coleman T, Guyton A, Cowley A Jr, Bower J, Norman R Jr, Manning R Jr (1977) Feedback mechanisms of arterial pressure control. Contrib Nephrol 8:5
Constant I, Laude D, Murat I, Elghozi JL (1999) Pulse rate variability is not a surrogate for heart rate variability. Clin Sci 97:391–397
Costa M, Moody GB, Henry I, Goldberger AL (2003) PhysioNet: an NIH research resource for complex signals. J Electrocardiol 36:139–144
Cybulski G, Michalak E, Koźluk E, Piatkowska A, Niewiadomski W (2004) Stroke volume and systolic time intervals: beat-to-beat comparison between echocardiography and ambulatory impedance cardiography in supine and tilted positions. Med Biol Eng Comput 42(5):707–711
Doerr DF, Ratliff DA, Sithole J, Convertino VA (2005) Stroke volume during orthostatic challenge: comparison of two non-invasive methods. Aviat Space Environ Med 76(10):935–939
Duschek S, Reyes del Paso GA (2007) Quantification of cardiac baroreflex function at rest and during autonomic stimulation. J Physiol Sci 57(5):259–268
Duschek S, Muckenthaler M, Werner N, Reyes del Paso GA (2009) Relationships between features of autonomic cardiovascular control and cognitive performance. Biol Psychol 81(2):110–117
Eckberg DL (1997) Sympathovagal balance: a critical appraisal. Circulation 96(9):3224
Fagard RH, Pardaens K, Staessen JA, Thijs L (1996) Prognostic value of invasive hemodynamic measurements at rest and during exercise in hypertensive men. Hypertension 28(1):31–36
Force T (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 93(5):1043–1065
Friedman BH, Thayer JF (1998) Anxiety and autonomic flexibility: a cardiovascular approach. Biol Psychol 47(3):243–263
Friedman BH, Thayer JF (1998) Autonomic balance revisited: panic anxiety and heart rate variability. J Psychosom Res 44(1):133–151
Friedman BH, Allen MT, Christie IC, Santucci AK (2002) Validity concerns of common heart-rate variability indices. IEEE Eng Med Biol Mag 21(4):35–40
Frijda NH (1988) The laws of emotion. Am Psychol 43(5):349
Giardino ND, Lehrer PM, Edelberg R (2002) Comparison of finger plethysmograph to ECG in the measurement of heart rate variability. Psychophysiology 39(2):246–253
Gregg ME, Matyas TA, James JE (2002) A new model of individual differences in hemodynamic profile and blood pressure reactivity. Psychophysiology 39(1):64–72
Hansen AL, Johnsen BH, Eid J, Sollers JJ, Thayer JF (2004) Hjerteratevariabilitet: En lovende tilnaerming til studiet av psykologiske prosesser, vol 41
Hesse C, Charkoudian N, Liu Z, Joyner MJ, Eisenach JH (2007) Baroreflex sensitivity inversely correlates with ambulatory blood pressure in healthy normotensive humans. Hypertension 50(1):41
Hill L, Siebenbrock A, Sollers J, Thayer J (2009) All are measures created equal? Heart rate variability and respiration. Biomed Sci Instrum 45:71–76
Hon EH (1958) The electronic evaluation of the fetal heart rate: preliminary report. Obstet Gynecol Surv 13(5):654
Houtveen JH, Rietveld S, Geus EJC (2002) Contribution of tonic vagal modulation of heart rate, central respiratory drive, respiratory depth, and respiratory frequency to respiratory sinus arrhythmia during mental stress and physical exercise. Psychophysiology 39(4):427–436
Institute of Medicine (US) Committee on Metabolic Monitoring for Military Field Applications (2004) Monitoring metabolic status: predicting decrements in physiological and cognitive performance. National Academies Press
Jensen L, Yakimets J, Teo KK (1995) A review of impedance cardiography. Heart Lung 24(3):183–193
Jose AD, Collison D (1970) The normal range and determinants of the intrinsic heart rate in man. Cardiovasc Res 4(2):160–167
Kay SM, Marple SL Jr (1981) Spectrum analysis – a modern perspective. Proc IEEE 69(11):1380–1419
Kitney R (1980) An analysis of the thermoregulatory influences on heart-rate variability. In: The study of heart rate variability. Clarendon Press, pp 81–106
Kupper N, Willemsen G, Boomsma DI, de Geus EJC (2006) Heritability of indices for cardiac contractility in ambulatory recordings. J Cardiovasc Electrophysiol 17(8):877–883
La Rovere M, Bigger J Jr, Marcus F, Mortara A, Schwartz P (1998) Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet 351(9101):478–484
Levy M (1997) Neural control of cardiac function. Baillieres Clin Neurol 6(2):227
Levy MN, Martin PJ (1996) Autonomic control of cardiac conduction and automaticity. In: Nervous control of the heart. Harwood Academic Publishers, Amsterdam, pp 201–226
Levy M, Zieske H (1969) Autonomic control of cardiac pacemaker activity and atrioventricular transmission. J Appl Physiol 27(4):465
Lipsitz LA, Goldberger AL (1992) Loss of “complexity” and aging. JAMA 267(13):1806
Lohmeier TE (2001) The sympathetic nervous system and long-term blood pressure regulation. Am J Hypertens 14(6):S147–S154
Lohmeier TE, Irwin ED, Rossing MA, Serdar DJ, Kieval RS (2004) Prolonged activation of the baroreflex produces sustained hypotension. Hypertension 43(2):306
Mager D, Merritt M, Kasturi J, Witkin L, Urdiqui-Macdonald M, Sollers J III, Evans M, Zonderman A, Abernethy D, Thayer J (2004) Kullback-Leibler clustering of continuous wavelet transform measures of heart rate variability. Biomed Sci Instrum 40:337
Malik M, Camm AJ (1993) Components of heart rate variability – what they really mean and what we really measure. Am J Cardiol 72(11):821
Malliani A, Pagani M, Lombardi F (1994) Methods for assessment of sympatho-vagal balance: power spectral analysis. In: Vagal control of the heart: Experimental basis and clinical implications. Futura, pp 433–454
Malmivuo J, Plonsey R (1995) Bioelectromagnetism: principles and applications of bioelectric and biomagnetic fields. Oxford University Press
McGrath JJ, O’Brien WH, Hassinger HJ, Shah P (2005) Comparability of spot versus band electrodes for impedance cardiography. J Psychophysiol 19(3):195
McKinley PS, Shapiro PA, Bagiella E, Myers MM, De Meersman RE, Grant I, Sloan RP (2003) Deriving heart period variability from blood pressure waveforms. J Appl Physiol 95(4):1431
Mensah GA, Pappas TW, Koren MJ, Ulin RJ, Laragh JH, Devereux RB (1993) Comparison of classification of the severity of hypertension by blood pressure level and by World Health Organization criteria in the prediction of concurrent cardiac abnormalities and subsequent complications in essential hypertension. J Hypertens 11(12):1429
Metin A (1997) Fast algorithms for wavelet transform computation. In: Time frequency and wavelets in biomedical signal processing. IEEE Press, pp 211–222
Miller SB, Ditto B (1988) Cardiovascular responses to an extended aversive video game task. Psychophysiology 25(2):200–206
Moak JP, Goldstein DS, Eldadah BA, Saleem A, Holmes C, Pechnik S, Sharabi Y (2007) Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Heart Rhythm 4(12):1523–1529
Neumann SA, Waldstein SR, Sellers JJ III, Thayer JF, Sorkin JD (2004) Hostility and distraction have differential influences on cardiovascular recovery from anger recall in women. Health Psychol 23(6):631
Neumann SA, Lawrence EC, Jennings JR, Ferrell RE, Manuck SB (2005) Heart rate variability is associated with polymorphic variation in the choline transporter gene. Psychosom Med 67(2):168
Niskanen JP, Tarvainen MP, Ranta-aho PO, Karjalainen PA (2004) Software for advanced HRV analysis. Comput Methods Prog Biomed 76:73–81
Ottaviani C, Shapiro D, Goldstein IB, James JE, Weiss R (2006) Hemodynamic profile, compensation deficit, and ambulatory blood pressure. Psychophysiology 43(1):46–56
Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell’Orto S, Piccaluga E (1986) Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 59(2):178–193
Parati G, Di Rienzo M, Mancia G (2000) How to measure baroreflex sensitivity: from the cardiovascular laboratory to daily life. J Hypertens 18(1):7
Penaz J (1978) Mayer waves: history and methodology. Automedica 2:135–141
Peng CK, Buldyrev SV, Hausdorff JM, Havlin S, Mietus JE, Simons M, Stanley HE, Goldberger AL (1994) Non-equilibrium dynamics as an indispensable characteristic of a healthy biological system. Integr Psychol Behav Sci 29(3):283–293
Penttilä J, Helminen A, Jartti T, Kuusela T, Huikuri HV, Tulppo MP, Coffeng R, Scheinin H (2001) Time domain, geometrical and frequency domain analysis of cardiac vagal outflow: effects of various respiratory patterns. Clin Physiol 21(3):365–376
Pincus SM (2001) Assessing serial irregularity and its implications for health. Ann N Y Acad Sci 954(1):245–267
Pincus SM, Gladstone IM, Ehrenkranz RA (1991) A regularity statistic for medical data analysis. J Clin Monit Comput 7(4):335–345
Pomeranz B, Macaulay R, Caudill MA, Kutz I, Adam D, Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ (1985) Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol Heart Circ Physiol 248(1):H151
Porges SW (1992) Autonomic regulation and attention. In: Attention and information processing in infants and adults: perspectives from human and animal research. Lawrence Erlbaum Associates, pp 201–223
Porges SW (1995) Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A polyvagal theory. Psychophysiology 32(4):301–318
Porges SW, Doussard Roosevelt JA, Portales AL, Greenspan SI (1996) Infant regulation of the vagal “brake” predicts child behavior problems: a psychobiological model of social behavior. Dev Psychobiol 29(8):697–712
Porges SW, Doussard-Roosevelt JA, Stifter CA, McClenny BD, Riniolo TC (1999) Sleep state and vagal regulation of heart period patterns in the human newborn: an extension of the polyvagal theory. Psychophysiology 36(01):14–21
Pozzati A, Pancaldi LG, Di Pasquale G, Pinelli G, Bugiardini R (1996) Transient sympathovagal imbalance triggers “ischemic” sudden death in patients undergoing electrocardiographic Holter monitoring. J Am Coll Cardiol 27(4):847
Ring C, Burns VE, Carroll D (2002) Shifting hemodynamics of blood pressure control during prolonged mental stress. Psychophysiology 39(5):585–590
Roach D, Wilson W, Ritchie D, Sheldon R (2004) Dissection of long-range heart rate variability: controlled induction of prognostic measures by activity in the laboratory. J Am Coll Cardiol 43(12):2271–2277
Saul JP (1990) Beat-to-beat variations of heart rate reflect modulation of cardiac autonomic outflow. Physiology 5(1):32
Sayers B (1973) Analysis of heart rate variability. Ergonomics 16(1):17
Sherwood A, Dolan CA, Light KC (1990) Hemodynamics of blood pressure responses during active and passive coping. Psychophysiology 27(6):656–668
Sherwood A, Allen M, Fahrenberg J, Kelsey R, Lovallo W, Van Doornen L (1990) Methodological guidelines for impedance cardiography. Psychophysiology 27(1):1
Snieder H, Dong Y, Barbeau P, Harshfield GA, Dalageogou C, Zhu H, Carter ND, Treiber FA (2002) Beta 2-adrenergic receptor gene and resting hemodynamics in European and African American youth. Am J Hypertens 15:973–979
Snieder H, Harshfield GA, Treiber FA (2003) Heritability of blood pressure and hemodynamics in African- and European-American youth. Hypertension 41(6):1196
Snieder H, van Doornen LJP, Boomsma DI, Thayer JF (2007) Sex differences and heritability of two indices of heart rate dynamics: a twin study. Twin Res Hum Genet 10(2):364–372
Sollers JJ III, Sanford TA, Nabors-Oberg R, Anderson CA, Thayer JF (2002) Examining changes in HRV in response to varying ambient temperature. IEEE Eng Med Biol Mag 21(4):30–34
Stein PK, Kleiger RE (1999) Insights from the study of heart rate variability. Annu Rev Med 50(1):249–261
Stemmler G, Grossman P, Schmid H, Foerster F (1991) A model of cardiovascular activation components for studies using autonomic receptor antagonists. Psychophysiology 28(4):367–382
Sztajzel J (2004) Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss Med Wkly 134:514–522
Tang W, Arnett DK, Devereux RB, Province MA, Atwood LD, Oberman A, Hopkins PN, Kitzman DW (2002) Sibling resemblance for left ventricular structure, contractility, and diastolic filling. Hypertension 40(3):233–238
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93:1043–1065
Thayer JF (2006) On the importance of inhibition: central and peripheral manifestations of nonlinear inhibitory processes in neural systems. Dose-Response 4(1):2–21
Thayer JF, Brosschot JF (2005) Psychosomatics and psychopathology: looking up and down from the brain. Psychoneuroendocrinology 30(10):1050–1058
Thayer JF, Friedman BH (1997) The heart of anxiety: a dynamical systems approach. In: The (non) expression of emotions in health and disease. Springer, pp 39–49
Thayer JF, Friedman BH (2004) A neurovisceral integration model of health disparities in aging. In: Critical perspectives on racial and ethnic differences in health in late life. National Academies Press
Thayer JF, Lane RD (2000) A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord 61(3):201–216
Thayer JF, Lane RD (2007) The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 74(2):224–242
Thayer JF, Lane RD (2009) Claude Bernard and the heart-brain connection: further elaboration of a model of neurovisceral integration. Neurosci Biobehav Rev 33(2):81–88
Thayer JF, Siegle GJ (2002) Neurovisceral integration in cardiac and emotional regulation. IEEE Eng Med Biol Mag 21(4):24–29
Thayer JF, Sternberg E (2006) Beyond heart rate variability. Ann N Y Acad Sci 1088(1):361–372
Thayer J, Uijtdehaage S (2001) Derivation of chronotropic indices of autonomic nervous system activity using impedance cardiography. Biomed Sci Instrum 37:331
Thayer JF, Sollers JJ III, Ruiz-Padial E, Vila J (2002) Estimating respiratory frequency from autoregressive spectral analysis of heart period. IEEE Eng Med Biol Mag 21(4):41–45
Thayer JF, Merritt MM, Sollers JJ (2003) Effect of angiotensin-converting enzyme insertion/deletion polymorphism DD genotype on high-frequency heart rate variability in African Americans. Am J Cardiol 92(12):1487–1490
Thayer JF, Hansen AL, Sollers JJ III, Johnsen BH (2005) Heart rate variability as an index of prefrontal neural function in military settings. Proc SPIE 5797:71–77
Thayer JF, Hansen AL, Saus-Rose E, Johnsen BH (2009) Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med 37(2):141–153
Thayer JF, Yamamoto SS, Brosschot JF (2010) The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 141(2):122–131
Thrasher TN (2006) Arterial baroreceptor input contributes to long-term control of blood pressure. Curr Hypertens Rep 8(3):249–254
Tzeng Y, Larsen P, Galletly D (2003) Cardioventilatory coupling in resting human subjects. Exp Physiol 88(6):775
Uijtdehaage SHJ, Thayer JF (2000) Accentuated antagonism in the control of human heart rate. Clin Auton Res 10(3):107–110
Wallin BG (2006) Regulation of sympathetic nerve traffic to skeletal muscle in resting humans. Clin Auton Res 16(4):262–269
Wang X, Thayer JF, Treiber F, Snieder H (2005) Ethnic differences and heritability of heart rate variability in African- and European American youth. Am J Cardiol 96(8):1166–1172
Wang X, Ding X, Su S, Li Z, Riese H, Thayer JF, Treiber F, Snieder H (2009) Genetic influences on heart rate variability at rest and during stress. Psychophysiology 46(3):458–465
Wesseling K, Jansen J, Settels J, Schreuder J (1993) Computation of aortic flow from pressure in humans using a nonlinear, three-element model. J Appl Physiol 74(5):2566
Yang T, Levy MN (1992) Sequence of excitation as a factor in sympathetic-parasympathetic interactions in the heart. Circ Res 71(4):898
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature
About this entry
Cite this entry
Thayer, J.F., Hansen, A.L., Johnsen, B.H. (2022). The Assessment of Autonomic Influences on the Heart Using Impedance Cardiography and Heart Rate Variability. In: Waldstein, S.R., Kop, W.J., Suarez, E.C., Lovallo, W.R., Katzel, L.I. (eds) Handbook of Cardiovascular Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-85960-6_38
Download citation
DOI: https://doi.org/10.1007/978-0-387-85960-6_38
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-85959-0
Online ISBN: 978-0-387-85960-6
eBook Packages: Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences