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Review Open Access

Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review)

  • Authors:
    • Asaf Gitler
    • Yoav Bar Yosef
    • Uri Kotzer
    • Ariel D. Levine
  • View Affiliations / Copyright

    Affiliations: Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel, Hematology Institute, Tel Aviv Sourasky Medical Center (Ichilov Hospital), Tel Aviv 6423906, Israel, Kotzer Psychological Services, Ganei Tikva 5591166, Israel, Department of Orthopedic Surgery, Bnai Zion Medical Center, Haifa 31048, Israel
    Copyright: © Gitler et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 37
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    Published online on: April 29, 2025
       https://doi.org/10.3892/mi.2025.236
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Abstract

The autonomic nervous system plays a central role in maintaining physiological homeostasis, with the vagus nerve as a crucial component. Heart rate variability (HRV) is a non‑invasive biomarker of vagal tone and autonomic flexibility. A reduced HRV has been associated with cardiovascular diseases, hypertension, inflammation and mental health disorders. The present narrative review discusses two promising non‑invasive interventions designed to enhance vagal activity: HRV biofeedback (HRV‑B) and the safe and sound protocol (SSP). HRV‑B utilizes paced breathing at an individual's resonance frequency combined with real‑time HRV monitoring to strengthen baroreflex sensitivity, improve autonomic balance, reduce systemic inflammation and enhance emotional regulation. Extensive research supports the efficacy of HRV‑B in improving cardiovascular outcomes, managing hypertension, reducing depressive and anxiety symptoms, and fostering resilience. By contrast, SSP is a relatively newer auditory‑based intervention grounded in the polyvagal theory. It targets the ventral vagal complex through filtered music to promote social engagement, emotional regulation, and parasympathetic activation. Preliminary studies suggest SSP may benefit individuals with autism spectrum disorder, post‑traumatic stress disorder and cardiovascular disease; however, large‑scale controlled trials are needed to validate its clinical efficacy. By bridging cardiovascular, neurological and psychological domains, both HRV‑B and SSP offer innovative non‑invasive strategies for promoting health and resilience. The review highlights the mechanisms, clinical applications, and outcomes associated with each approach, while also discussing current limitations, such as individual variability, adherence challenges, and the need for further research. Future directions include integrating wearable HRV monitoring, AI‑driven adaptive biofeedback, and expanding investigation across diverse populations to optimize clinical protocols. Together, HRV‑B and SSP represent promising avenues for enhancing vagal neuromodulation in both preventive and therapeutic settings.
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1 

GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 390:1151–1210. 2017.PubMed/NCBI View Article : Google Scholar

2 

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet. 396:1204–1222. 2020.PubMed/NCBI View Article : Google Scholar

3 

Qin M, Lee K and Yoo SJ: The impact of long COVID on heart rate variability: A cross-sectional study. BMC Infect Dis. 25(261)2025.PubMed/NCBI View Article : Google Scholar

4 

Corrado J, Iftekhar N, Halpin S, Li M, Tarrant R, Grimaldi J, Simms A, O'Connor RJ, Casson A and Sivan M: HEART Rate Variability Biofeedback for LOng COVID Dysautonomia (HEARTLOC): Results of a Feasibility Study. Adv Rehabil Sci Pract. 13(27536351241227261)2024.PubMed/NCBI View Article : Google Scholar

5 

Godin PJ and Buchman TG: Uncoupling of biological oscillators: A complementary hypothesis concerning the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med. 24:1107–1116. 1996.PubMed/NCBI View Article : Google Scholar

6 

Gidron Y, De Couck M, Reynders T, Marechal R, Engelborghs S and D'hooghe AM: Stronger correlations between neurophysiological and peripheral disease biomarkers predict better prognosis in two severe diseases. J Clin Med. 9(26)2019.PubMed/NCBI View Article : Google Scholar

7 

Kenney MJ and Ganta CK: Autonomic nervous system and immune system interactions. Compr Physiol. 4:1177–200. 2014.PubMed/NCBI View Article : Google Scholar

8 

Câmara R and Griessenauer CJ: Anatomy of the vagus nerve. In: Nerves and Nerve Injuries. Academic Press, Cambridge, MA, pp385-397, 2015.

9 

Wink J, van Delft R, Notenboom RGE, Wouters PF, DeRuiter MC, Plevier JWM and Jongbloed MRM: Human adult cardiac autonomic innervation: Controversies in anatomical knowledge and relevance for cardiac neuromodulation. Auton Neurosci. 227(102674)2020.PubMed/NCBI View Article : Google Scholar

10 

Goehler LE, Gaykema RP, Hansen MK, Anderson K, Maier SF and Watkins LR: Vagal immune-to-brain communication: A visceral chemosensory pathway. Auton Neurosci. 85:49–59. 2000.PubMed/NCBI View Article : Google Scholar

11 

Tracey KJ: Reflex control of immunity. Nat Rev Immunol. 9:418–428. 2009.PubMed/NCBI View Article : Google Scholar

12 

Rosas-Ballina M, Olofsson PS, Ochani M, Valdés-Ferrer SI, Levine YA, Reardon C, Tusche MW, Pavlov VA, Andersson U, Chavan S, et al: Acetylcholine-synthesizing T cells relay neural signals in a vagus nerve circuit. Science. 334:98–101. 2011.PubMed/NCBI View Article : Google Scholar

13 

Lehrer P: How does heart rate variability biofeedback work? Resonance, the baroreflex, and other mechanisms. Biofeedback. 41:26–31. 2013.PubMed/NCBI View Article : Google Scholar

14 

Barthel P, Wensel R, Bauer A, Müller A, Wolf P, Ulm K, Huster KM, Francis DP, Malik M and Schmidt G: Respiratory rate predicts outcome after acute myocardial infarction: A prospective cohort study. Eur Heart J. 34:1644–1650. 2013.PubMed/NCBI View Article : Google Scholar

15 

Gitler A, Vanacker L, De Couck M, De Leeuw I and Gidron Y: Neuromodulation applied to diseases: The case of HRV biofeedback. J Clin Med. 11(5927)2022.PubMed/NCBI View Article : Google Scholar

16 

Thayer JF, Hansen AL, Saus-Rose E and Johnsen BH: Heart rate variability, prefrontal neural function, and cognitive performance: The neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med. 37:141–153. 2009.PubMed/NCBI View Article : Google Scholar

17 

Thayer JF, Ahs F, Fredrikson M, Sollers JJ III and Wager TD: A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 36:747–756. 2012.PubMed/NCBI View Article : Google Scholar

18 

Kim HG, Cheon EJ, Bai DS, Lee YH and Koo BH: Stress and heart rate variability: A meta-analysis and review of the literature. Psychiatry Investig. 15:235–245. 2018.PubMed/NCBI View Article : Google Scholar

19 

Matusik PS, Zhong C, Matusik PT, Alomar O and Stein PK: Neuroimaging studies of the neural correlates of heart rate variability: A systematic review. J Clin Med. 12(1016)2023.PubMed/NCBI View Article : Google Scholar

20 

Thayer JF and Lane RD: A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord. 61:201–216. 2000.PubMed/NCBI View Article : Google Scholar

21 

Lane RD, McRae K, Reiman EM, Chen K, Ahern GL and Thayer JF: Neural correlates of heart rate variability during emotion. Neuroimage. 44:213–222. 2009.PubMed/NCBI View Article : Google Scholar

22 

Friedman BH: An autonomic flexibility-neurovisceral integration model of anxiety and cardiac vagal tone. Biol Psychol. 74:185–199. 2007.PubMed/NCBI View Article : Google Scholar

23 

Feliciano L and Henning RJ: Vagal nerve stimulation releases vasoactive intestinal peptide, which significantly increases coronary artery blood flow. Cardiovasc Res. 40:45–55. 1998.PubMed/NCBI View Article : Google Scholar

24 

Vaupel P and Mayer A: Hypoxia in cancer: Significance and impact on clinical outcome. Cancer Metastasis Res. 26:225–239. 2007.PubMed/NCBI View Article : Google Scholar

25 

Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 93:1043–1065. 1996.PubMed/NCBI

26 

Kuo TB, Lai CJ, Huang YT and Yang CC: Regression analysis between heart rate variability and baroreflex-related vagus nerve activity in rats. J Cardiovasc Electrophysiol. 16:864–869. 2005.PubMed/NCBI View Article : Google Scholar

27 

Laborde S, Mosley E and Thayer JF: Heart rate variability and cardiac vagal tone in psychophysiological research-recommendations for experiment planning, data analysis, and data reporting. Front Psychol. 8(213)2017.PubMed/NCBI View Article : Google Scholar

28 

Shaffer F and Mae JV: Heart rate variability anatomy and physiology. Biofeedback (Online). 41(13)2013.

29 

Reyes del Paso GA, Langewitz W, Mulder LJ, van Roon A and Duschek S: The utility of low-frequency heart rate variability as an index of sympathetic cardiac tone: A review with emphasis on a reanalysis of previous studies. Psychophysiology. 50:477–487. 2013.PubMed/NCBI View Article : Google Scholar

30 

Munoz ML, van Roon A, Riese H, Thio C, Oostenbroek E, Westrik I, de Geus EJ, Gansevoort R, Lefrandt J, Nolte IM and Snieder HH: Validity of (ultra-)short recordings for heart rate variability measurements. PLoS One. 10(e0138921)2015.PubMed/NCBI View Article : Google Scholar

31 

Rautaharju PM, Kooperberg C, Larson JC and LaCroix A: Electrocardiographic predictors of incident congestive heart failure and all-cause mortality in postmenopausal women: The Women's Health Initiative. Circulation. 113:481–489. 2006.PubMed/NCBI View Article : Google Scholar

32 

Dekker JM, Schouten EG, Klootwijk P, Pool J, Swenne CA and Kromhout D: Heart rate variability from short electrocardiographic recordings predicts mortality from all causes in middle-aged and elderly men. The Zutphen Studyy. Am J Epidemiol. 145:899–908. 1997.PubMed/NCBI View Article : Google Scholar

33 

De Couck M, Maréchal R, Moorthamers S, Van Laethem JL and Gidron YY: Vagal nerve activity predicts overall survival in metastatic pancreatic cancer, mediated by inflammation. Cancer Epidemiol. 40:47–51. 2016.PubMed/NCBI View Article : Google Scholar

34 

Weber CS, Thayer JF, Rudat M, Wirtz PH, Zimmermann-Viehoff F, Thomas A, Perschel FH, Arck PC and Deter HC: Low vagal tone is associated with impaired post-stress recovery of cardiovascular, endocrine, and immune markers. Eur J Appl Physiol. 109:201–211. 2010.PubMed/NCBI View Article : Google Scholar

35 

Beauchaine TP and Thayer JF: Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol. 98:338–350. 2015.PubMed/NCBI View Article : Google Scholar

36 

Cohen S, Frank E, Doyle WJ, Skoner DP, Rabin BS and Gwaltney JM Jr: Types of stressors that increase susceptibility to the common cold in healthy adults. Health Psychol. 17:214–223. 1998.PubMed/NCBI View Article : Google Scholar

37 

Jackson CA, Sudlow CL and Mishra GD: Psychological distress and risk of myocardial infarction and stroke in the 45 and up study. Circ Cardiovasc Qual Outcomes. 11(e004500)2018.PubMed/NCBI View Article : Google Scholar

38 

Otzenberger H, Gronfier C, Simon C, Charloux A, Ehrhart J, Piquard F and Brandenberger G: Dynamic heart rate variability: A tool for exploring sympathovagal balance continuously during sleep in men. Am J Physiol. 275:H946–H950. 1998.PubMed/NCBI View Article : Google Scholar

39 

Kleiger RE, Stein PK and Bigger JT Jr: Heart rate variability: Measurement and clinical utility. Ann Noninvasive Electrocardiol. 10:88–101. 2005.PubMed/NCBI View Article : Google Scholar

40 

Penttilä J, Helminen A, Jartti T, Kuusela T, Huikuri HV, Tulppo MP, Coffeng R and Scheinin H: Time domain, geometrical and frequency domain analysis of cardiac vagal outflow: Effects of various respiratory patterns. Clin Physiol. 21:365–376. 2001.PubMed/NCBI View Article : Google Scholar

41 

Berntson GG, Lozano DL and Chen YJ: Filter properties of root mean square successive difference (RMSSD) for heart rate. Psychophysiology. 42:246–252. 2005.PubMed/NCBI View Article : Google Scholar

42 

Tsuji H, Venditti FJ, Manders ES, Evans JC, Larson MG, Feldman CL and Levy D: Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation. 90:878–883. 1994.PubMed/NCBI View Article : Google Scholar

43 

Buccelletti E, Gilardi E, Scaini E, Galiuto L, Persiani R, Biondi A, Basile F and Silveri NG: Heart rate variability and myocardial infarction: Systematic literature review and metanalysis. Eur Rev Med Pharmacol Sci. 13:299–307. 2009.PubMed/NCBI

44 

De Couck M and Gidron Y: Norms of vagal nerve activity, indexed by Heart Rate Variability, in cancer patients. Cancer Epidemiol. 37:737–741. 2013.PubMed/NCBI View Article : Google Scholar

45 

Zhou X, Ma Z, Zhang L, Zhou S, Wang J, Wang B and Fu W: Heart rate variability in the prediction of survival in patients with cancer: A systematic review and meta-analysis. J Psychosom Res. 89:20–25. 2016.PubMed/NCBI View Article : Google Scholar

46 

Huikuri HV, Pikkujämsä SM, Airaksinen KE, Ikäheimo MJ, Rantala AO, Kauma H, Lilja M and Kesäniemi YA: Sex-related differences in autonomic modulation of heart rate in middle-aged subjects. Circulation. 94:122–125. 1996.PubMed/NCBI View Article : Google Scholar

47 

Singh JP, Larson MG, Tsuji H, Evans JC, O'Donnell CJ and Levy D: Reduced heart rate variability and new-onset hypertension: Insights into pathogenesis of hypertension: The Framingham Heart Study. Hypertension. 32:293–297. 1998.PubMed/NCBI View Article : Google Scholar

48 

Huston JM and Tracey KJ: The pulse of inflammation: Heart rate variability the cholinergic anti-inflammatory pathway and implications for therapy. J Intern Med. 269:45–53. 2011.PubMed/NCBI View Article : Google Scholar

49 

Sajadieh A, Nielsen OW, Rasmussen V, Hein HO, Abedini S and Hansen JF: Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J. 25:363–370. 2004.PubMed/NCBI View Article : Google Scholar

50 

Benichou T, Pereira B, Mermillod M, Tauveron I, Pfabigan D, Maqdasy S and Dutheil F: Heart rate variability in type 2 diabetes mellitus: A systematic review and meta-analysis. PLoS One. 13(e0195166)2018.PubMed/NCBI View Article : Google Scholar

51 

Gidron Y, Deschepper R, De Couck M, Thayer JF and Velkeniers B: The vagus nerve can predict and possibly modulate non-communicable chronic diseases, introducing a neuroimmunological paradigm to public health. J Clin Med. 7(371)2018.PubMed/NCBI View Article : Google Scholar

52 

Greten FR and Grivennikov SI: Inflammation and cancer: Triggers mechanisms, and consequences. Immunity. 51:27–41. 2019.PubMed/NCBI View Article : Google Scholar

53 

Aeschbacher S, Schoen T, Dörig L, Kreuzmann R, Neuhauser C, Schmidt-Trucksäss A and Conen D: Heart rate, heart rate variability, and inflammatory biomarkers among young and healthy adults. Ann Med. 49:32–41. 2017.PubMed/NCBI View Article : Google Scholar

54 

Araújo F, Antelmi I, Pereira AC, Maria do Rosário DO, Grupi CJ, Krieger JE and Mansur AJ: Lower heart rate variability is associated with higher serum high-sensitivity C-reactive protein concentration in healthy individuals aged 46 years or more. Int J Cardiol. 107:333–337. 2006.PubMed/NCBI View Article : Google Scholar

55 

Lampert R, Bremner JD, Su S, Miller A, Lee F, Cheema F and Vaccarino V: Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men. Am Heart J. 156:759.e1–e7. 2008.PubMed/NCBI View Article : Google Scholar

56 

Jarczok MN, Koenig J, Mauss D, Fischer JE and Thayer JF: Lower heart rate variability predicts increased level of C-reactive protein 4 years later in healthy, nonsmoking adults. J Intern Med. 276:667–671. 2014.PubMed/NCBI View Article : Google Scholar

57 

Stein PK, Schmieg RE Jr, El-Fouly A, Domitrovich PP and Buchman TG: Association between heart rate variability recorded on postoperative day 1 and length of stay in abdominal aortic surgery patients. Crit Care Med. 29:1738–1743. 2001.PubMed/NCBI View Article : Google Scholar

58 

Powezka K, Adjei T, von Rosenberg W, Normahani P, Goverdovsky V, Standfield NJ and Jaffer U: A pilot study of preoperative heart rate variability predicting pain during local anesthetic varicose vein surgery. J Vasc Surg Venous Lymphat Disord. 7:382–386. 2019.PubMed/NCBI View Article : Google Scholar

59 

Gitler A, Levine AD, Ayub AEA, Munteanu AG, Lulu OB and Gidron Y: Preoperative vagal activity predicts clinical outcomes after total knee replacement. Exp Ther Med. 28(393)2024.PubMed/NCBI View Article : Google Scholar

60 

Nunan D, Sandercock GR and Brodie DA: A quantitative systematic review of normal values for short-term heart rate variability in healthy adults. Pacing Clin Electrophysiol. 33:1407–1417. 2010.PubMed/NCBI View Article : Google Scholar

61 

O'Neal WT, Chen LY, Nazarian S and Soliman EZ: Reference ranges for short-term heart rate variability measures in individuals free of cardiovascular disease: The Multi-Ethnic Study of Atherosclerosis (MESA). J Electrocardiol. 49:686–690. 2016.PubMed/NCBI View Article : Google Scholar

62 

Van den Berg ME, Rijnbeek PR, Niemeijer MN, Hofman A, van Herpen G, Bots ML, Hillege H, Swenne CA, Eijgelsheim M, Stricker BH and Kors JA: Normal values of corrected heart-rate variability in 10-second electrocardiograms for all ages. Front Physiol. 9(424)2018.PubMed/NCBI View Article : Google Scholar

63 

Nussinovitch U, Elishkevitz KP, Kaminer K, Nussinovitch M, Segev S, Volovitz B and Nussinovitch N: The efficiency of 10-second resting heart rate for the evaluation of short-term heart rate variability indices. Pacing Clin Electrophysiol. 34:1498–1502. 2011.PubMed/NCBI View Article : Google Scholar

64 

Lanska DJ: Corning and vagal nerve stimulation for seizures in the 1880s. Neurology. 58:452–459. 2002.PubMed/NCBI View Article : Google Scholar

65 

Silberstein SD, Mechtler LL, Kudrow DB, Calhoun AH, McClure C, Saper JR, Liebler EJ, Rubenstein Engel E and Tepper SJ: ACT1 Study Group. Non-Invasive Vagus Nerve Stimulation for the ACute treatment of cluster headache: Findings from the randomized, double-blind, sham-controlled ACT1 study. Headache. 56:1317–1332. 2016.PubMed/NCBI View Article : Google Scholar

66 

Silberstein SD, Calhoun AH, Lipton RB, Grosberg BM, Cady RK, Dorlas S, Simmons KA, Mullin C, Liebler EJ, Goadsby PJ, et al: Chronic migraine headache prevention with noninvasive vagus nerve stimulation: The EVENT study. Neurology. 87:529–538. 2016.PubMed/NCBI View Article : Google Scholar

67 

Lerman I, Hauger R, Sorkin L, Proudfoot J, Davis B, Huang A, Lam K, Simon B and Baker DG: Noninvasive transcutaneous vagus nerve stimulation decreases whole blood culture-derived cytokines and chemokines: A randomized, blinded, healthy control pilot trial. Neuromodulation. 19:283–291. 2016.PubMed/NCBI View Article : Google Scholar

68 

Stavrakis S, Stoner JA, Humphrey MB, Morris L, Filiberti A, Reynolds JC, Elkholey K, Javed I, Twidale N, Riha P, et al: TREAT AF (Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Atrial Fibrillation): A randomized clinical trial. JACC Clin Electrophysiol. 6:282–291. 2020.PubMed/NCBI View Article : Google Scholar

69 

Farmer AD, Strzelczyk A, Finisguerra A, Gourine AV, Gharabaghi A, Hasan A, Burger AM, Jaramillo AM, Mertens A, Majid A, et al: International consensus based review and recommendations for minimum reporting standards in research on transcutaneous vagus nerve stimulation (version 2020). Front Hum Neurosci. 14(568051)2021.PubMed/NCBI View Article : Google Scholar

70 

Goodnick PJ, Rush AJ, George MS, Marangell LB and Sackeim HA: Vagus nerve stimulation in depression. Expert Opin Pharmacother. 2:1061–1063. 2001.PubMed/NCBI View Article : Google Scholar

71 

Pruitt DT, Schmid AN, Kim LJ, Abe CM, Trieu JL, Choua C, Hays SA, Kilgard MP and Rennaker RL: Vagus nerve stimulation delivered with motor training enhances recovery of function after traumatic brain injury. J Neurotrauma. 33:871–879. 2016.PubMed/NCBI View Article : Google Scholar

72 

Dawson J, Liu CY, Francisco GE, Cramer SC, Wolf SL, Dixit A, Alexander J, Ali R, Brown BL, Feng W, et al: Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): A randomised, blinded, pivotal, device trial. Lancet. 397:1545–1553. 2021.PubMed/NCBI View Article : Google Scholar

73 

Straube A, Ellrich J, Eren O, Blum B and Ruscheweyh R: Treatment of chronic migraine with transcutaneous stimulation of the auricular branch of the vagal nerve (auricular t-VNS): A randomized, monocentric clinical trial. J Headache Pain. 16(543)2015.PubMed/NCBI View Article : Google Scholar

74 

Gaul C, Diener HC, Silver N, Magis D, Reuter U, Andersson A, Liebler EJ and Straube A: PREVA Study Group. PREVA Study Group: Non-invasive vagus nerve stimulation for PREVention and Acute treatment of chronic cluster headache (PREVA): A randomised controlled study. Cephalalgia. 36:534–546. 2016.PubMed/NCBI View Article : Google Scholar

75 

Genheimer H, Andreatta M, Asan E and Pauli P: Reinstatement of contextual conditioned anxiety in virtual reality and the effects of transcutaneous vagus nerve stimulation in humans. Sci Rep. 7(17886)2017.PubMed/NCBI View Article : Google Scholar

76 

Morris GL III, Gloss D, Buchhalter J, Mack KJ, Nickels K and Harden C: Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 81:1453–1459. 2013.PubMed/NCBI View Article : Google Scholar

77 

Young AH, Juruena MF, De Zwaef R and Demyttenaere K: Vagus nerve stimulation as adjunctive therapy in patients with difficult-to-treat depression (RESTORE-LIFE): Study protocol design and rationale of a real-world post-market study. BMC Psychiatry. 20(471)2020.PubMed/NCBI View Article : Google Scholar

78 

DeGiorgio CM and Krahl SE: Neurostimulation for drug-resistant epilepsy. Continuum (Minneap Minn). 19:743–755. 2013.PubMed/NCBI View Article : Google Scholar

79 

Ben-Menachem E, Revesz D, Simon BJ and Silberstein S: Surgically implanted and non-invasive vagus nerve stimulation: A review of efficacy, safety and tolerability. Eur J Neurol. 22:1260–1268. 2015.PubMed/NCBI View Article : Google Scholar

80 

Frangos E, Ellrich J and Komisaruk BR: Non-invasive access to the vagus nerve central projections via electrical stimulation of the external ear: FMRI evidence in humans. Brain Stimul. 8:624–636. 2015.PubMed/NCBI View Article : Google Scholar

81 

Redgrave J, Day D, Leung H, Laud PJ, Ali A, Lindert R and Majid A: Safety and tolerability of transcutaneous vagus nerve stimulation in humans; a systematic review. Brain Stimul. 11:1225–1238. 2018.PubMed/NCBI View Article : Google Scholar

82 

Grazzi L, Tassorelli C, de Tommaso M, Pierangeli G, Martelletti P, Rainero I, Geppetti P, Ambrosini A, Sarchielli P, Liebler E, et al: Practical and clinical utility of non-invasive vagus nerve stimulation (nVNS) for the acute treatment of migraine: A post hoc analysis of the randomized, sham-controlled, double-blind PRESTO trial. J Headache Pain. 19(98)2018.PubMed/NCBI View Article : Google Scholar

83 

Khodaparast N, Hays SA, Sloan AM, Fayyaz T, Hulsey DR, Rennaker RL II and Kilgard MP: Vagus nerve stimulation delivered during motor rehabilitation improves recovery in a rat model of stroke. Neurorehabil Neural Repair. 28:698–706. 2014.PubMed/NCBI View Article : Google Scholar

84 

Capone F, Miccinilli S, Pellegrino G, Zollo L, Simonetti D, Bressi F, Florio L, Ranieri F, Falato E, Di Santo A, et al: Transcutaneous vagus nerve stimulation combined with robotic rehabilitation improves upper limb function after stroke. Neural Plast. 2017(7876507)2017.PubMed/NCBI View Article : Google Scholar

85 

Clancy JA, Mary DA, Witte KK, Greenwood JP, Deuchars SA and Deuchars J: Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity. Brain Stimul. 7:871–877. 2014.PubMed/NCBI View Article : Google Scholar

86 

Murray AR, Atkinson L, Mahadi MK, Deuchars SA and Deuchars J: The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control. Auton Neurosci. 199:48–53. 2016.PubMed/NCBI View Article : Google Scholar

87 

Yuan H and Silberstein SD: Vagus nerve and vagus nerve stimulation, a comprehensive review: Part III. Headache. 56:479–490. 2016.PubMed/NCBI View Article : Google Scholar

88 

Carreno FR and Frazer A: Vagal nerve stimulation for treatment-resistant depression. Neurotherapeutics. 14:716–727. 2017.PubMed/NCBI View Article : Google Scholar

89 

Mertens A, Raedt R, Gadeyne S, Carrette E, Boon P and Vonck K: Recent advances in devices for vagus nerve stimulation. Expert Rev Med Devices. 15:527–539. 2018.PubMed/NCBI View Article : Google Scholar

90 

Wang Y, Zhan G, Cai Z, Jiao B, Zhao Y, Li S and Luo A: Vagus nerve stimulation in brain diseases: Therapeutic applications and biological mechanisms. Neurosci Biobehav Rev. 127:37–53. 2021.PubMed/NCBI View Article : Google Scholar

91 

Li S, Scherlag BJ, Yu L, Sheng X, Zhang Y, Ali R, Dong Y, Ghias M and Po SS: Low-level vagosympathetic stimulation: A paradox and potential new modality for the treatment of focal atrial fibrillation. Circ Arrhythm Electrophysiol. 2:645–651. 2009.PubMed/NCBI View Article : Google Scholar

92 

Stavrakis S, Humphrey MB, Scherlag BJ, Hu Y, Jackman WM, Nakagawa H, Lockwood D, Lazzara R and Po SS: Low-level transcutaneous electrical vagus nerve stimulation suppresses atrial fibrillation. J Am Coll Cardiol. 65:867–875. 2015.PubMed/NCBI View Article : Google Scholar

93 

Brock C, Brock B, Aziz Q, Møller HJ, Pfeiffer Jensen M, Drewes AM and Farmer AD: Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha. Neurogastroenterol Motil: Dec 12, 2016 (Epub ahead of print). doi: 10.1111/nmo.12999.

94 

Wheat AL and Larkin KT: Biofeedback of heart rate variability and related physiology: A critical review. Appl Psychophysiol Biofeedback. 35:229–242. 2010.PubMed/NCBI View Article : Google Scholar

95 

Lehrer P, Vaschillo B, Zucker T, Graves J, Katsamanis M, Aviles M and Wamboldt F: Protocol for heart rate variability biofeedback training. Biofeedback. 41:98–109. 2013.

96 

De Couck M, Caers R, Musch L, Fliegauf J, Giangreco A and Gidron Y: How breathing can help you make better decisions: Two studies on the effects of breathing patterns on heart rate variability and decision-making in business cases. Int J Psychophysiol. 139:1–9. 2019.PubMed/NCBI View Article : Google Scholar

97 

Hamasaki H: Effects of diaphragmatic breathing on health: A narrative review. Medicines (Basel). 7(65)2020.PubMed/NCBI View Article : Google Scholar

98 

Ley R: Blood, breath, and fears: A hyperventilation theory of panic attacks and agoraphobia. Clin Psychology Rev. 5:271–285. 1985.

99 

Tavel ME: Hyperventilation syndrome: Why is it regularly overlooked? Am J Med. 134:13–15. 2021.PubMed/NCBI View Article : Google Scholar

100 

Laborde S, Allen MS, Borges U, Dosseville F, Hosang TJ, Iskra M, Mosley E, Salvotti C, Spolverato L, Zammit N and Javelle F: Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neurosci Biobehav Rev. 138(104711)2022.PubMed/NCBI View Article : Google Scholar

101 

Porges S: Vagal nerve stimulation through the lens of the polyvagal theory: Recruiting neurophysiological mechanisms to dampen threat reactions and promote homeostatic functions. In: Vagus Nerve Stimulation. Springer, New York, NY, pp31-49, 2023.

102 

Neuhuber WL and Berthoud HR: Functional anatomy of the vagus system: How does the polyvagal theory comply? Biol Psychol. 174(108425)2022.PubMed/NCBI View Article : Google Scholar

103 

Kawai H, Kishimoto M, Okahisa Y, Sakamoto S, Terada S and Takaki M: Initial outcomes of the safe and sound protocol on patients with adult autism spectrum disorder: Exploratory pilot study. Int J Environ Res Public Health. 20(4862)2023.PubMed/NCBI View Article : Google Scholar

104 

Porges SW and Dana D (eds): Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies. WW Norton & Company, New York, NY, 2018.

105 

Heilman KJ, Heinrich S, Ackermann M, Nix E and Kyuchukov H: Effects of the safe and sound protocol tm (ssp) on sensory processing, digestive function and selective eating in children and adults with autism: A prospective single-arm study. Journal on Developmental Disabilities. 2:1–26. 2023.

106 

Vaschillo EG, Vaschillo B and Lehrer PM: Characteristics of resonance in heart rate variability stimulated by biofeedback. Appl Psychophysiol Biofeedback. 31:129–142. 2006.PubMed/NCBI View Article : Google Scholar

107 

Karavaev AS, Kiselev AR, Gridnev VI, Borovkova EI, Prokhorov MD, Posnenkova OM, Ponomarenkova OM, Ponomarenko VI, Bezruchko BP and Shvarts VA: Phase and frequency locking of 0.1-Hz oscillations in heart rate and baroreflex control of blood pressure by breathing of linearly varying frequency as determined in healthy subjects. Human Physiology. 39:416–425. 2013.PubMed/NCBI

108 

Vaschillo E, Lehrer P, Rishe N and Konstantinov M: Heart rate variability biofeedback as a method for assessing baroreflex function: A preliminary study of resonance in the cardiovascular system. Appl Psychophysiol Biofeedback. 27:1–27. 2002.PubMed/NCBI View Article : Google Scholar

109 

Lehrer PM and Gevirtz R: Heart rate variability biofeedback: How and why does it work? Front Psychol. 5(756)2014.PubMed/NCBI View Article : Google Scholar

110 

Lehrer PM, Vaschillo E, Vaschillo B, Lu SE, Scardella A, Siddique M and Habib RH: Biofeedback treatment for asthma. Chest. 126:352–361. 2004.PubMed/NCBI View Article : Google Scholar

111 

DeBoer RW, Karemaker JM and Strackee J: Hemodynamic fluctuations and baroreflex sensitivity in humans: A beat-to-beat model. Am J Physiol. 253:H680–H689. 1987.PubMed/NCBI View Article : Google Scholar

112 

Vaschillo E, Vaschillo B and Lehrer P: Heartbeat synchronizes with respiratory rhythm only under specific circumstances. Chest. 126:1385–1386. 2004.PubMed/NCBI View Article : Google Scholar

113 

Bernardi L, Gabutti A, Porta C and Spicuzza L: Slow breathing reduces chemoreflex response to hypoxia and hypercapnia, and increases baroreflex sensitivity. J Hypertens. 19:2221–2229. 2001.PubMed/NCBI View Article : Google Scholar

114 

Yasuma F and Hayano JI: Respiratory sinus arrhythmia: Why does the heartbeat synchronize with respiratory rhythm? Chest. 125:683–690. 2004.PubMed/NCBI View Article : Google Scholar

115 

Gevirtz R: The nerve of that disease: The vagus nerve and cardiac rehabilitation. Biofeedback. 41:32–38. 2013.

116 

Tracey KJ: Physiology and immunology of the cholinergic anti-inflammatory pathway. J Clin Invest. 117:289–296. 2007.

117 

Purcell E, Shaffer F and Urlakis M: Brief resonance frequency training can reduce C-reactive protein. History of HRV Research 96 Fall 2013. Biofeedback levels in normals [Abstract]. Presented at the Meeting of the Association for Applied Psychophysiology and Biofeedback, New Orleans, LA, 2011.

118 

Herhaus B, Conrad R and Petrowski K: Effect of a slow-paced breathing with heart rate variability biofeedback intervention on pro-inflammatory cytokines in individuals with panic disorder-A randomized controlled trial. J Affect Disord. 326:132–138. 2023.PubMed/NCBI View Article : Google Scholar

119 

Goessl VC, Curtiss JE and Hofmann SG: The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis. Psychol Med. 47:2578–2586. 2017.PubMed/NCBI View Article : Google Scholar

120 

Lehrer P, Kaur K, Sharma A, Shah K, Huseby R, Bhavsar J, Sgobba P and Zhang Y: Correction to: Heart rate variability biofeedback improves emotional and physical health and performance: A systematic review and meta analysis. Appl Psychophysiol Biofeedback. 46(389)2021.PubMed/NCBI View Article : Google Scholar

121 

Pizzoli SF, Marzorati C, Gatti D, Monzani D, Mazzocco K and Pravettoni G: A meta-analysis on heart rate variability biofeedback and depressive symptoms. Sci Rep. 11(6650)2021.PubMed/NCBI View Article : Google Scholar

122 

Fournié C, Chouchou F, Dalleau G, Caderby T, Cabrera Q and Verkindt C: Heart rate variability biofeedback in chronic disease management: A systematic review. Complement Ther Med. 60(102750)2021.PubMed/NCBI View Article : Google Scholar

123 

Brinza C, Floria M, Covic A, Covic A, Scripcariu DV and Burlacu A: The usefulness of assessing heart rate variability in patients with acute myocardial infarction (HeaRt-V-AMI). Sensors (Basel). 22(3571)2022.PubMed/NCBI View Article : Google Scholar

124 

Ross R: Atherosclerosis-an inflammatory disease. N Engl J Med. 340:115–126. 1999.PubMed/NCBI View Article : Google Scholar

125 

Farahi L, Sinha SK and Lusis AJ: Roles of macrophages in atherogenesis. Front Pharmacol. 12(785220)2021.PubMed/NCBI View Article : Google Scholar

126 

Tsutsumi S, Gotoh T, Tomisato W, Mima S, Hoshino T, Hwang HJ, Takenaka H, Tsuchiya T, Mori M and Mizushima T: Endoplasmic reticulum stress response is involved in nonsteroidal anti-inflammatory drug-induced apoptosis. Cell Death Differ. 11:1009–1016. 2004.PubMed/NCBI View Article : Google Scholar

127 

Lin IM, Fan SY, Lu HC, Lin TH, Chu CS, Kuo HF, Lee CS and Lu YH: Randomized controlled trial of heart rate variability biofeedback in cardiac autonomic and hostility among patients with coronary artery disease. Behav Res Ther. 70:38–46. 2015.PubMed/NCBI View Article : Google Scholar

128 

Chida Y and Steptoe A: The association of anger and hostility with future coronary heart disease: A meta-analytic review of prospective evidence. J Am Coll Cardiol. 53:936–946. 2009.PubMed/NCBI View Article : Google Scholar

129 

Climov D, Lysy C, Berteau S, Dutrannois J, Dereppe H, Brohet C and Melin J: Biofeedback on heart rate variability in cardiac rehabilitation: Practical feasibility and psycho-physiological effects. Acta Cardiol. 69:299–307. 2014.PubMed/NCBI View Article : Google Scholar

130 

Limmer A, Laser M and Schütz A: Mobile heart rate variability biofeedback as a complementary intervention after myocardial infarction: A randomized controlled study. Int J Behav Med. 29:230–239. 2022.PubMed/NCBI View Article : Google Scholar

131 

Yu LC, Lin IM, Fan SY, Chien CL and Lin TH: One-year cardiovascular prognosis of the randomized, controlled, short-term heart rate variability biofeedback among patients with coronary artery disease. Int J Behav Med. 25:271–282. 2018.PubMed/NCBI View Article : Google Scholar

132 

Nolan RP, Floras JS, Harvey PJ, Kamath MV, Picton PE, Chessex C, Hiscock N, Powell J, Catt M, Hendrickx H, et al: Behavioral neurocardiac training in hypertension: A randomized, controlled trial. Hypertension. 55:1033–1039. 2010.PubMed/NCBI View Article : Google Scholar

133 

Schroeder EB: Determinants of the Longitudinal Change in Heart Rate Variability: The Atherosclerosis Risk in Communities Study. University of North Carolina at Chapel Hill, Chapel Hill, NC, 2013.

134 

Lin G, Xiang Q, Fu X, Wang S, Wang S, Chen S, Shao L, Zhao Y and Wang T: Heart rate variability biofeedback decreases blood pressure in prehypertensive subjects by improving autonomic function and baroreflex. J Altern Complement Med. 18:143–152. 2012.PubMed/NCBI View Article : Google Scholar

135 

Rau H, Bührer M and Weitkunat R: Biofeedback of R-wave-to-pulse interval normalizes blood pressure. Appl Psychophysiol Biofeedback. 28:37–46. 2003.PubMed/NCBI View Article : Google Scholar

136 

Kishimoto M, Sekido Y, Kawai H and Takaki M: Effects of safe and sound protocol system on psychological and physiological functions of children with autism spectrum disorders: Preliminary findings. J Psychol Psychother. 13:1–10. 2023.

137 

Fang SC, Wu YL and Tsai PS: Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: A meta-analysis of cohort studies. Biol Res Nurs. 22:45–56. 2020.PubMed/NCBI View Article : Google Scholar

138 

Steptoe A and Kivimäki M: Stress and cardiovascular disease: An update on current knowledge. Annu Rev Public Health. 34:337–354. 2013.PubMed/NCBI View Article : Google Scholar

139 

Cohen S: Social relationships and health. Am Psychol. 59:676–684. 2004.PubMed/NCBI View Article : Google Scholar

140 

Berkman LF, Kawachi I and Glymour MM (eds): Social Epidemiology. 2nd edition. Oxford University Press, 2014.

141 

Coughlin SS: Post-traumatic stress disorder and cardiovascular disease. Open Cardiovasc Med J. 5:164–170. 2011.PubMed/NCBI View Article : Google Scholar

142 

Padhi BK, Khatib MN, Serhan HA, Gaidhane AM, Rustagi S, Zahiruddin QS, Sharma RK and Satapathy P: Cardiovascular impact of post-traumatic stress disorder: A systematic review and meta-analysis. Curr Probl Cardiol. 49(102632)2024.PubMed/NCBI View Article : Google Scholar

143 

Roy SS, Foraker RE, Girton RA and Mansfield AJ: Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans. Am J Public Health. 105:757–763. 2015.PubMed/NCBI View Article : Google Scholar

144 

Naber D and Bullinger M: Psychiatric sequelae of cardiac arrest. Dialogues Clin Neurosci. 20:73–77. 2018.PubMed/NCBI View Article : Google Scholar

145 

Princip M, Ledermann K and von Känel R: Posttraumatic stress disorder as a consequence of acute cardiovascular disease. Curr Cardiol Rep. 25:455–465. 2023.PubMed/NCBI View Article : Google Scholar

146 

Kenemore J, Benham G, Charak R and Hernandez Rodriguez J: Heart rate variability biofeedback as a treatment for military PTSD: A Meta-analysis. Mil Med. 189:e1903–e1909. 2024.PubMed/NCBI View Article : Google Scholar

147 

Smith TW, Deits-Lebehn C, Caska-Wallace CM, Renshaw KD and Uchino BN: Resting high-frequency heart rate variability and PTSD symptomatology in Veterans: Effects of respiration, role in elevated heart rate, and extension to spouses. Biol Psychol. 154(107928)2020.PubMed/NCBI View Article : Google Scholar

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Spandidos Publications style
Gitler A, Bar Yosef Y, Kotzer U and Levine AD: Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review). Med Int 5: 37, 2025.
APA
Gitler, A., Bar Yosef, Y., Kotzer, U., & Levine, A.D. (2025). Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review). Medicine International, 5, 37. https://doi.org/10.3892/mi.2025.236
MLA
Gitler, A., Bar Yosef, Y., Kotzer, U., Levine, A. D."Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review)". Medicine International 5.4 (2025): 37.
Chicago
Gitler, A., Bar Yosef, Y., Kotzer, U., Levine, A. D."Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review)". Medicine International 5, no. 4 (2025): 37. https://doi.org/10.3892/mi.2025.236
Copy and paste a formatted citation
x
Spandidos Publications style
Gitler A, Bar Yosef Y, Kotzer U and Levine AD: Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review). Med Int 5: 37, 2025.
APA
Gitler, A., Bar Yosef, Y., Kotzer, U., & Levine, A.D. (2025). Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review). Medicine International, 5, 37. https://doi.org/10.3892/mi.2025.236
MLA
Gitler, A., Bar Yosef, Y., Kotzer, U., Levine, A. D."Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review)". Medicine International 5.4 (2025): 37.
Chicago
Gitler, A., Bar Yosef, Y., Kotzer, U., Levine, A. D."Harnessing non‑invasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review)". Medicine International 5, no. 4 (2025): 37. https://doi.org/10.3892/mi.2025.236
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