Heart rate variability-based autonomic nervous system (ANS) monitoring represents a revolution in health care. The field of heart rate variability research has demonstrated its significance and usefulness in a growing number of applied clinical areas. Here is what some experts and the media are saying about ANS testing. (Article and abstract names listed in green can be clicked on to view, read, or download).

Recent Abstracts and News

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2006

Heart Rate Variability and Feeding Bradycardia in Healthy Preterm Infants During Transition From Gavage to Oral Feeding FYI - You must have Adobe Acrobat Reader installed to view this document; Adobe Acrobat Reader is a free download - click here if you want to download the free Adobe Acrobat reader.

2005

JOGNN November/December 2005 Heart Rate Variability Responses of a Preterm Infant to Kangaroo Care (Case Study) Interesting case study which examines the effect of Kangaroo Care (I.E. the placement of an infant in prone position and skin to skin on the mother's chest)on HRV in a healthy preterm infant.FYI - You must have Adobe Acrobat Reader installed to view this document; Adobe Acrobat Reader is a free download - click here if you want to download the free Adobe Acrobat reader.

April 2005 : Diabetes Care vol 28, #4 Diabetic Neuropathies - A Statement by The American Diabetes Association A great article extoling the benefits of non-invasive testing for CAN and DAN, as well as the measurement of HRV with recommendations for screening and treatment. FYI - You must have Adobe Acrobat Reader installed to view this document; Adobe Acrobat Reader is a free download - click here if you want to download the free Adobe Acrobat reader.

2004

William C. Shoemaker, MD, of Los Angeles County and University of Southern California Medical Center has found that Autonomic Nervous System (ANS) monitoring from Ansar, Inc. of Philadelphia, PA can improve the prediction of survivability and can enhance indications of mortality and morbidity in critically ill or injured patients. Dr. Shoemaker is the recipient of the first life time achievement award in Critical Care. For over six years, he has been using Ansar's ANS monitoring technology to monitor patients from entry to the ER through discharge from the ICU.

June 2004 : A fellow of Dr. Shoemaker's publishes first ANS monitoring in Critical Care/Trauma article: "Autonomic Activity in Trauma Patients Based on Variability of Heart Rate and Respiratory Rate".

May 2004 : Dr. Shoemaker presents to Philips Medical Systems the need for Ansar technology in central station critical care monitoring.

April 2004 : Dr. Shoemaker submits article co-authored with Ansar: "ANS Monitoring Detects Sepsis Earlier."

Dr. David Roeltgen from West Branch Neurology, Williamsport, PA, recently presented the following information to the American Academy of Neurology in San Francisco, CA. The presentation was well received. Dr. David Roeltgen at 2004 American Academy of Neurology: 

2003

Jan 2003 : Dr. Shoemaker receives the Society of Critical Care Medicine's 1st Life Time Achievement Award

May 2003 : Diabetes Care 26 - (Journal of the American Diabetes Association) - Technical Review: Standard of Care: Diabetic Autonomic Neuropathy

May 2003 : Diabetes Care 26: David S.H. Bell, MB, FACE - Heart Failure - The frequent, forgotten, and often fatal complication of diabetes

2002

Brian M Curtis, MD, and James H. O'Keefe Jr, MD : "Autonomic Tone as a Cardiovascular Risk Factor: The Dangers of Chronic Fight or Flight."

2000

Nov 2000 : Dr. Shoemaker has co-authored with Ansar a medical school text book chapter : "Non-invasive Autonomic Nervous System Monitoring in Critical Care" in Textbook of Critical Care, 3rd ed.

The media:

Peter Jennings : Tonight we are going to take "A Closer Look" at the heart… Tonight's report from ABC's John McKenzie is about a completely new definition of just what is a healthy heart*.

John McKenzie, ABC News : Like the ticking of a metronome, we can find remarkable order all around us - the daily sunsets, the rising tides, the changing colors of the season; but increasingly, scientists are looking beneath the order, focusing instead on just how variable, how complex, how ultimately unpredictable nature can be. And they're discovering this apparent chaos, so fundamental in our environment, is actually critical to our health. Scientists are now actually applying this variability of nature to the human body.

Dr. James Willerson, Texas Heart Institute : Variability has always been important. It has simply been that physicians have not recognized that appropriately in the past.

John McKenzie : Scientists, taking their lessons from nature's irregularity, began analyzing heart rhythms and discovered that people with a truly steady, predictable heartbeat are at significantly higher risk of heart failure and sudden death, and those with a heart rate that's constantly changing, ever so slightly, are more likely to be in good health.

Dr. Ary Goldberger, Harvard Medical School : The healthiest systems, in a way, are the most responsive. If you think about it, what you really want is a system that can respond or react to a wide variety of different stresses, different stimuli.

Dr. James Willerson : Variability in heart rate will be used as a screening test and possibly as an early sign that the heart is injured in one way or another, even when all other tests are normal.

* ABC News, ABC Transcript #8288, New York, NY: June 30, 1998.

More from the experts:

The most sensitive, repeatable, and practical measure of autonomic function uses the measure of heart rate variability (HRV) in response to provocative stimuli such as deep breathing, blowing under pressure, or standing. HRV has become the 'gold standard' for characterizing autonomic nervous system (ANS) function and dysfunction, and has the added benefits of being simple and non-invasive. HRV testing is recognized as useful in the characterization of autonomic function and dysfunction in consensus statements by the American Diabetes Association (ADA)* and the American Academy of Neurology (AAN)**, and in standards of care issued by the American Academy of Clinical Endocrinologists (AACE)*** and the American Heart Association (AHA)****  (p. 8)*****

In the analysis of stationary short-term recordings, more experience and theoretical knowledge exist on physiological interpretation of the frequency domain measures compared with the time domain measures derived from the same recordings. (p. 1041)******

Although the time domain methods, especially the SDNN and the RMSDD methods, can be used to investigate recordings of short durations, the frequency methods are usually able to provide results that are more easily interpretable in terms of physiological regulations.

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