The specific aims are: 1) To compare frequency of complex ventricular ectopy, events of sudden cardiac arrest, and survival rate between randomized treatment and control groups of persons at risk of sudden cardiac arrest before and after self-management/biofeedback therapy over a period of two years. A comparison of mortality rates and recurrent events of sudden cardiac arrest will also be made between the treatment group and all the subjects in two large registries of sudden cardiac arrests/deaths. 2) To compare the non-spectral and power spectral measurements of heart rate variability (HRV), perceived control, affective states (i.e., depression, anxiety, etc.), psychosocial adaptation, functional status, and quality of life between randomized treatment and control groups of persons at risk of sudden cardiac arrest before and after self-management/biofeedback therapy over a period of one year. 3) To describe the relationships between the aforementioned variables at the same points in time (i.e., cross-sectional periods). 4) To describe the normative values of the non-spectral and power spectral measurements of HRV in a group of persons without cardiac disease and compare these values with persons at risk of sudden cardiac arrest. The design is a randomized, two-group, experimental, repeated measures, longitudinal study. The sample size is 65 in each of the treatment at exit, and at follow-up times at 6 and 12 months. Mortality and recurrent events of sudden cardiac arrest will be tracked at 2-year follow-up through two registries. Forty subjects without cardiac disease will be studied to describe normative values of HRV. The biobehavioral interventions: self-management therapy is focused on training sudden cardiac survivors to cognitively alter their cognitive/affective states and increase HRV by use of the respiratory sinus arrhythmia (that is, heart rate will increase and decrease in phase with respirations as tidal volume is increased and breathing rate is decreased). The respiratory sinus arrhythmia is primarily parasympathetic. Power spectral analysis of HRV enables separation of the parasympathetic and sympathetic components. Statistical analysis includes log-rank test and Cox proportional hazards regression model, analysis of variance for repeated measures, analysis of covariance, regression analysis, and t-tests.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
1R01NR001970-01A3
Application #
3391896
Study Section
Nursing Research Study Section (NURS)
Project Start
1991-08-31
Project End
1996-07-31
Budget Start
1991-08-31
Budget End
1992-07-31
Support Year
1
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Washington
Department
Type
Schools of Nursing
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
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Burr, Robert L; Motzer, Sandra A; Chen, Wan et al. (2003) Logit50: a nonlinear transformation of pNN50 with improved statistical properties. J Electrocardiol 36:41-52
Cowan, M J; Pike, K C; Budzynski, H K (2001) Psychosocial nursing therapy following sudden cardiac arrest: impact on two-year survival. Nurs Res 50:68-76
Cowan, M J (1995) Measurement of heart rate variability. West J Nurs Res 17:32-48;discussion 101-11
Burr, R; Hamilton, P; Cowan, M et al. (1994) Nycthemeral profile of nonspectral heart rate variability measures in women and men. Description of a normal sample and two sudden cardiac arrest subsamples. J Electrocardiol 27 Suppl:54-62
Cowan, M J; Pike, K; Burr, R L (1994) Effects of gender and age on heart rate variability in healthy individuals and in persons after sudden cardiac arrest. J Electrocardiol 27 Suppl:1-9
Cowan, M J; Pike, K; Burr, R L et al. (1993) Description of time- and frequency- domain-based measures of heart rate variability in individuals taking antiarrhythmics, beta blockers, calcium channel blockers, and/or antihypertensive drugs after sudden cardiac arrest. J Electrocardiol 26 Suppl:1-13
Cowan, M J; Burr, R L; Narayanan, S B et al. (1992) Comparison of autoregression and fast Fourier transform techniques for power spectral analysis of heart period variability of persons with sudden cardiac arrest before and after therapy to increase heart period variability. J Electrocardiol 25 Suppl:234-9