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Biofeedback Assisted Control of Respiratory Sinus Arrhythmia as a Biobehavioral Intervention for Depressive Symptoms in Patients After Cardiac Surgery: A Preliminary Study

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Abstract

The current study investigated whether biofeedback training aimed at increasing respiratory sinus arrhythmia (RSA), a measure of cardiac vagal modulation, can reduce depressive symptoms in patients after cardiac surgery. This randomized controlled study enrolled 26 patients after first-time cardiac surgery. The patients were randomly assigned to an RSA-biofeedback group (N = 13) or to a treatment as usual group (N = 13). The biofeedback training consisted of five 45 min sessions designed to increase RSA. The outcome was assessed as changes in RSA and in the Centre for Epidemiologic Studies of Depression (CES-D) values from pre- to post-training. Both groups were comparable for demographic and biomedical characteristics. RSA increased significantly in patients who underwent RSA-biofeedback compared to controls. Moreover, the CES-D scores were reduced significantly from pre- to post-training in the RSA-biofeedback group compared to the controls. Changes in RSA were inversely related to changes in CES-D scores from pre- to post-training. These findings extend the effectiveness of RSA-biofeedback for increasing vagal modulation as well as for reducing depressive symptoms in post-surgical patients. Overall, the current study also suggests that this biobehavioral intervention may add to the efficacy of postoperative risk reduction programs and rehabilitation protocols in cardiac surgery patients.

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Acknowledgments

Funds for this study were provided by Motta di Livenza Hospital, Treviso, for the PhD student grant for Ms. Patron and by the European Social Fund (ref. 2105/101/1/722/2009) for the PhD student grant for Dr. Messerotti Benvenuti.

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Authors and Affiliations

  1. Department of General Psychology, University of Padova, Via Venezia, 8, 35131, Padova, Italy

    Elisabetta Patron, Simone Messerotti Benvenuti, Carlotta Bonfà & Daniela Palomba

  2. Department of Preventive and Rehabilitative Cardiology, Motta di Livenza Hospital, Via Padre Leonardo Bello, 3/c, 31045, Motta di Livenza (TV), Italy

    Giuseppe Favretto, Carlo Valfrè & Renata Gasparotto

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  1. Elisabetta Patron
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  2. Simone Messerotti Benvenuti
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  3. Giuseppe Favretto
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Correspondence to Elisabetta Patron.

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Patron, E., Messerotti Benvenuti, S., Favretto, G. et al. Biofeedback Assisted Control of Respiratory Sinus Arrhythmia as a Biobehavioral Intervention for Depressive Symptoms in Patients After Cardiac Surgery: A Preliminary Study. Appl Psychophysiol Biofeedback 38, 1–9 (2013). https://doi.org/10.1007/s10484-012-9202-5

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