Association between heart rate variability and ECG changes in on-duty prehospital physicians
Background/objectivesPrehospital emergency physicians work in physically and psychologically stressful environments. During their shifts, changes in electrocardiogram (ECG) attributable to stress have been described previously. Alterations in heart rate variability (HRV) as well as in ST-T segments...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2025.1617377/full |
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| author | Mathias Maleczek Mathias Maleczek Karl Schebesta Karl Schebesta Thomas Hamp Balthasar Laussner Thomas Pezawas Mario Krammel Mario Krammel Bernhard Roessler Bernhard Roessler |
| author_facet | Mathias Maleczek Mathias Maleczek Karl Schebesta Karl Schebesta Thomas Hamp Balthasar Laussner Thomas Pezawas Mario Krammel Mario Krammel Bernhard Roessler Bernhard Roessler |
| author_sort | Mathias Maleczek |
| collection | DOAJ |
| description | Background/objectivesPrehospital emergency physicians work in physically and psychologically stressful environments. During their shifts, changes in electrocardiogram (ECG) attributable to stress have been described previously. Alterations in heart rate variability (HRV) as well as in ST-T segments have been reported. Nevertheless, the association between those two parameters still remains unclear in this setting.MethodsA retrospective analysis of data collected in a previous prospective trial was conducted. The primary objective was the association of HRV metrics with the risk of ST-T abnormalities during 5-min intervals and on a mission basis. Therefore, the root mean square of successive differences (RMSSD) and standard deviation of normal-to-normal (SDNN) intervals were analysed. Additionally, variations in HRV during different phases of a mission were investigated.ResultsData of 20 physicians was analysed. SDNN was positively associated with ST-T abnormalities both on a 5 min basis (OR: 1.04, 95%CI: 1.03-1.04) and a mission basis while RMSSD was negatively associated with ST-T abnormalities evaluated per mission (OR: 0.73, 95%CI: 0.57-0.93). pNN50 was not associated with ST-T abnormalities. During patient care and patient transport HRV was significantly lower than during alarm and en-route of a rescue mission.ConclusionNo reliable correlation between HRV values and the occurrence of ST-T segment changes during missions in prehospital emergency physicians were found. Therefore, it is questionable whether HRV alone is sufficient to detect ischemia-like changes during stressful events. |
| format | Article |
| id | doaj-art-ec4d9eb52efe442e926a8c1f2227ff55 |
| institution | Kabale University |
| issn | 1664-042X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj-art-ec4d9eb52efe442e926a8c1f2227ff552025-08-20T03:51:49ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-07-011610.3389/fphys.2025.16173771617377Association between heart rate variability and ECG changes in on-duty prehospital physiciansMathias Maleczek0Mathias Maleczek1Karl Schebesta2Karl Schebesta3Thomas Hamp4Balthasar Laussner5Thomas Pezawas6Mario Krammel7Mario Krammel8Bernhard Roessler9Bernhard Roessler10Medical Simulation and Emergency Management Research Group, Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, Vienna, AustriaAcademic Simulation Center Vienna, Vienna, AustriaMedical Simulation and Emergency Management Research Group, Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, Vienna, AustriaDepartment of Anaesthesia and Intensive Care Medicine, Orthopaedic Hospital Vienna – Speising, Vienna, AustriaEmergency Medical Service Vienna, Vienna, AustriaMedical Simulation and Emergency Management Research Group, Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, Vienna, AustriaDepartment of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, AustriaEmergency Medical Service Vienna, Vienna, AustriaPULS – Austrian Cardiac Arrest Awareness Association, Vienna, AustriaMedical Simulation and Emergency Management Research Group, Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, Vienna, AustriaAcademic Simulation Center Vienna, Vienna, AustriaBackground/objectivesPrehospital emergency physicians work in physically and psychologically stressful environments. During their shifts, changes in electrocardiogram (ECG) attributable to stress have been described previously. Alterations in heart rate variability (HRV) as well as in ST-T segments have been reported. Nevertheless, the association between those two parameters still remains unclear in this setting.MethodsA retrospective analysis of data collected in a previous prospective trial was conducted. The primary objective was the association of HRV metrics with the risk of ST-T abnormalities during 5-min intervals and on a mission basis. Therefore, the root mean square of successive differences (RMSSD) and standard deviation of normal-to-normal (SDNN) intervals were analysed. Additionally, variations in HRV during different phases of a mission were investigated.ResultsData of 20 physicians was analysed. SDNN was positively associated with ST-T abnormalities both on a 5 min basis (OR: 1.04, 95%CI: 1.03-1.04) and a mission basis while RMSSD was negatively associated with ST-T abnormalities evaluated per mission (OR: 0.73, 95%CI: 0.57-0.93). pNN50 was not associated with ST-T abnormalities. During patient care and patient transport HRV was significantly lower than during alarm and en-route of a rescue mission.ConclusionNo reliable correlation between HRV values and the occurrence of ST-T segment changes during missions in prehospital emergency physicians were found. Therefore, it is questionable whether HRV alone is sufficient to detect ischemia-like changes during stressful events.https://www.frontiersin.org/articles/10.3389/fphys.2025.1617377/fullHRVstressemergencycritical careprehospitalECG |
| spellingShingle | Mathias Maleczek Mathias Maleczek Karl Schebesta Karl Schebesta Thomas Hamp Balthasar Laussner Thomas Pezawas Mario Krammel Mario Krammel Bernhard Roessler Bernhard Roessler Association between heart rate variability and ECG changes in on-duty prehospital physicians Frontiers in Physiology HRV stress emergency critical care prehospital ECG |
| title | Association between heart rate variability and ECG changes in on-duty prehospital physicians |
| title_full | Association between heart rate variability and ECG changes in on-duty prehospital physicians |
| title_fullStr | Association between heart rate variability and ECG changes in on-duty prehospital physicians |
| title_full_unstemmed | Association between heart rate variability and ECG changes in on-duty prehospital physicians |
| title_short | Association between heart rate variability and ECG changes in on-duty prehospital physicians |
| title_sort | association between heart rate variability and ecg changes in on duty prehospital physicians |
| topic | HRV stress emergency critical care prehospital ECG |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2025.1617377/full |
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