Heart rate variability biofeedback: Current and potential applications.

Abstract

Heart rate variability (HRV) biofeedback offers clinicians an excellent and cost-effective technology for a number of mental health and behavioral conditions. Although it requires some training to administer, the technology has become very friendly and, for most psycho logists, certification-level training can be obtained with the equivalent of one or two 3-credit university courses, plus some supervision (for details of training requirements for becoming a certified biofeedback therapist, see http://www. bcia.org). Technical equipment costs range from handheld devices costing a few hundred dollars through research-grade multichannel devices costing several thousand. Some smartphone apps also are available for a few dollars, although the requirements to hold warm hands very steady in a spot where pulse amplitude is high (often above heart level) sometimes cause difficulty in pulse detection, in our experience.Google, PsycINFO, or Medline searches on HRV yield a large number of articles on the topic. They can be classified in two clusters: (a) papers showing the relationship between HRV and autonomic balance, and (b) those showing the relationship between HRV and adaptability (Berntson et al., 1997;Di Simplicio et al., 2012;Lehrer & Eddie, 2013). Both clusters are important for understanding how the body works and is regulated. Because HRV biofeedback is used primarily as a method for improving adaptability, we emphasize this interpretation here.