Resident Montefiore Medical Center/Albert Einstein College of Medicine Bronx, New York, United States
Introduction: Heart rate variability (HRV) reflects the activity of the autonomic nervous system (ANS) and can be used as a potential predictor of stress related cardiovascular diseases (CVD). This study aimed to assess whether physical and mental strain during the performance of cerebral endovascular procedure influence time-domain HRV parameters in operating surgeon.
Methods: HR and HRV metrics were measured using a heart rate sensor chest strap before, during and after neuroendovascular interventions performed by a single neurosurgeon. Three consecutive data series were reported by recording time domain: before procedure, during and after performing endovascular procedures. HR and HRV parameters were recorded during diagnostic and interventional neuroendovascular procedures. HR and HRV measures were analyzed by procedure type and recording time domain.
Results: HRV measures of a single endovascular neurosurgeon were recorded during 50 procedures. The median intraprocedural HRV score was the lowest and the median HR was the highest [HRV: 52, HR: 89 bpm] compared to preprocedural [HRV: 59, HR: 70 bpm] and postprocedural cardiovascular measures [HRV: 53, HR: 79, bpm, p < .001]. The median intra- and postprocedural HRV recorded during interventional procedures were lower than those recorded during diagnostic procedures (intraprocedural: 50 vs 53, Postprocedureal: 50 vs 55, respectively, p < .001). On univariate linear regression, a negative association of interventional procedures with lower intra- (β= -0.905, p=0.001) and postprocedural (β= -1.12, p < .001) HRV scores compared to the diagnostic procedures was noted.
Conclusion : HRV is a reliable tool to measure cardiovascular and mental stress. Interventional neuro-endovascular procedures seem to negatively impact the cardiovascular measures of neurointerventionalists. Further longitudinal studies utilizing HRV are warranted to address their long-term effects on the mental health of physicians.
