Heart rate variability biofeedback in chronic disease management: A systematic review

Background:
Heart rate variability biofeedback (HRVB) is a non-pharmacological intervention used to support the management of chronic diseases.

Method:
A systematic review was conducted based on studies that included adult patients with chronic conditions, where HRVB was applied as the main treatment (with or without control conditions), and psychophysiological outcomes were measured as dependent variables.

Results:
A total of 29 studies met the criteria. The findings demonstrate that HRVB is feasible and well-tolerated among chronic patients, with no reported adverse effects. Significant positive outcomes were observed across various patient groups, including those with hypertension and cardiovascular risk, inflammation, asthma, depression and anxiety, sleep disorders, cognitive decline, and chronic pain — all contributing to an improved quality of life. Notably, improvements in clinical outcomes were accompanied by increased heart rate variability, indicating a potential regulatory effect of HRVB on autonomic nervous system function.

Conclusions:
HRV biofeedback appears to be an effective and safe approach for managing chronic conditions. Further research is needed to confirm these findings and to identify the most efficient protocols for clinical use.

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