Surgical Recovery

Methods

Continuous HRV monitoring from 4 days pre to 9 days post-surgery

Key Findings

• SDNN and total power decreased post-surgery
• HRV remained suppressed for at least 9 days
• Return to preoperative values by 6-52 weeks
• Trend toward increased HRV leading up to surgery
• HRV may predict postoperative outcomes

Limitations

Single surgery type, individual variation

Methods

AHA/AACVPR scientific statement review of cardiac rehab

Key Findings

• Cardiac rehab increases exercise capacity and HRV
• Quality of life improvements documented
• Prehabilitation reduces postoperative complications
• Virtual/remote delivery expanding access
• Minimal risk of adverse effects

Limitations

Participation rates declining, access varies

Methods

Systematic review and pilot studies of pre-operative HRV

Key Findings

• Lower pre-op HRV associated with more complications
• HRV + age model achieved AUC of 0.98 for CV complications
• Post-operative HRV also predicts outcomes
• May help identify high-risk patients for closer monitoring
• Potential for personalized perioperative care

Limitations

Not yet standard of care, more validation needed

Methods

Continuous HRV monitoring through surgical procedures

Key Findings

• Both sympathetic and parasympathetic HRV components decrease
• Heart rate stabilizes faster than full HRV recovery
• Baroreflex function may take 24+ hours to recover
• Clinical hypnosis may preserve vagal activity
• Remote ischemic preconditioning may improve HRV

Limitations

Many anesthetic agents and protocols exist