Breathing Exercise Training for Rapid Heartbeat

Overseen By Madison Maxwell, B.S.

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Virginia Commonwealth University

Must not be taking: Narcotics, Hormones, others

Disqualifiers: Neurological disorders, Unstable medical disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 6 weeks

12 Participants Needed

Trial Summary

What is the purpose of this trial?

This study is being to see if participating in breathing exercise training and practicing this training will help with Postural tachycardia syndrome (POTS). The information may help doctors to learn more about how the different parts of people's brains communicate.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes those using certain unapproved drugs or medical devices, and those using hormones other than insulin, thyroid replacement, or oral contraceptives. It's best to discuss your specific medications with the trial team.

What data supports the effectiveness of the treatment Breathing Exercise Training for Rapid Heartbeat?

Research shows that breathing exercises can improve heart rate and mood, and reduce stress. In heart failure patients, breathing exercises have been shown to improve heart function and overall performance. Additionally, controlled breathing has been linked to better heart rate variability, which is a sign of a healthier heart. ^{1 2 3 4 5}

Is breathing exercise training safe for humans?

Breathing exercise training has been shown to be safe in studies involving patients with chronic heart failure and high blood pressure, with no reported adverse effects. ^{6 7 8 9 10}

How does Breathing Exercise Training differ from other treatments for rapid heartbeat?

Breathing Exercise Training is unique because it focuses on controlling the heart rate through specific breathing techniques, which can enhance heart rate variability and reduce blood pressure by modifying autonomic control. Unlike medications, this treatment uses natural breathing patterns to potentially improve heart function and mood without pharmacological intervention. ^{1 11 12 13 14}

Research Team

Thomas Chelimsky, M.D.

Principal Investigator

Virginia Commonwealth University

Eligibility Criteria

This trial is for English-speaking adults aged 18-50 with Postural Orthostatic Tachycardia Syndrome (POTS). It's not suitable for those with chronic neurological conditions other than POTS, inflammatory arthritis, autoimmune disorders, or unstable medical issues like severe kidney or liver problems and poorly controlled heart disease.

Inclusion Criteria

Can speak and read in English

I have an appointment at the VCU Autonomics Center in at least a week.

I have been diagnosed with POTS or experience fainting or near-fainting.

Exclusion Criteria

Investigators and study staff

I am not using hormones, except for insulin, thyroid replacements, or birth control.

Any on-going or pending medical, health or disability related litigation, or current pursuit of disability

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo breathing exercise training to improve vagal function and practice this training

6 weeks

Assessed at baseline, week 3, and week 6

Follow-up

Participants are monitored for changes in various psychological and physiological measures

4 weeks

Treatment Details

Interventions

• Breathing Exercise Training

Trial Overview The study tests if breathing exercise training can improve brain communication in people with POTS. Participants will practice these exercises to see their effect on the condition and brain function related to the periaqueductal gray area.

Participant Groups

Group I: Training Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

Virginia Commonwealth University

Lead Sponsor

Trials

732

Recruited

22,900,000+

Findings from Research

Heart Rate Variability Biofeedback (HRVB) can improve cardiovascular health by utilizing different breathing protocols, with three main types identified: Optimal RF, Individual RF, and Preset-pace RF, based on 143 studies reviewed.

Many studies lack detailed reporting on HRVB protocols, making it difficult to replicate results; thus, the authors recommend methodological guidelines to improve the quality and transparency of future HRVB research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Methods for Heart Rate Variability Biofeedback (HRVB): A Systematic Review and Guidelines. Lalanza, JF., Lorente, S., Bullich, R., et al.[2023]

Heart rate variability biofeedback (HRVB) training, particularly through resonance frequency (RF) breathing, significantly improves heart rate variability (HRV) and positive mood, as shown in a study with three groups of participants.

The RF breathing group exhibited a higher LF/HF HRV ratio and lower systolic blood pressure compared to the control group, indicating that RF breathing is an effective method for enhancing HRV and reducing stress responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood. Steffen, PR., Austin, T., DeBarros, A., et al.[2020]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Cardiorespiratory effects of breathing and relaxation instruction in myocardial infarction patients. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Breathing exercises and inspiratory muscle training in heart failure. [2014]

3. England pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of a controlled breathing protocol on heart rate variability following myocardial infarction or coronary artery bypass graft surgery. [2009]

4. United States pubmed.ncbi.nlm.nih.gov

Brief structured respiration practices enhance mood and reduce physiological arousal. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Cardiopulmonary rehabilitation enhances heart rate recovery in patients with COPD. [2012]

6. United States pubmed.ncbi.nlm.nih.gov

Respiratory feedback for treating panic disorder. [2019]

7. Germany pubmed.ncbi.nlm.nih.gov

Methods for Heart Rate Variability Biofeedback (HRVB): A Systematic Review and Guidelines. [2023]

8. Poland pubmed.ncbi.nlm.nih.gov

Effects of device‑guided slow breathing training on exercise capacity, cardiac function, and respiratory patterns during sleep in male and female patients with chronic heart failure. [2017]

9. England pubmed.ncbi.nlm.nih.gov

The effects of breathing training on dyspnea and anxiety among patients with acute heart failure at emergency department. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Device-guided breathing to lower blood pressure: case report and clinical overview. [2018]

11. Switzerland pubmed.ncbi.nlm.nih.gov

The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood. [2020]

12. Netherlands pubmed.ncbi.nlm.nih.gov

Enhanced cardiac vagal efferent activity does not explain training-induced bradycardia. [2009]

13. Czech Republic pubmed.ncbi.nlm.nih.gov

Slow breathing training reduces resting blood pressure and the pressure responses to exercise. [2020]

14. Germany pubmed.ncbi.nlm.nih.gov

Evaluation of Heart Rate Variability and Application of Heart Rate Variability Biofeedback: Toward Further Research on Slow-Paced Abdominal Breathing in Zen Meditation. [2022]