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J Adv Nurs. 2010 May;66(5):1101-10. doi: 10.1111/j.1365-2648.2010.05277.x.

Effectiveness of respiratory-sinus-arrhythmia biofeedback on state-anxiety in patients undergoing coronary angiography.

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Department of Internal Medicine 2, General Hospital Klagenfurt, Austria.



This study is a report of a study conducted to evaluate the value of psychological assistance including respiratory-sinus-arrhythmia biofeedback training in its ability to reduce the level of anxiety in patients undergoing coronary angiography.


Coronary angiography has been reported to cause anxiety and emotional stress.


Between March 2004 and January 2005, 212 patients undergoing routine elective coronary angiography for the evaluation of stable coronary artery disease were randomized into two groups. In the psychological support group (n = 106) a structured psychological conversation and respiratory-sinus-arrhythmia biofeedback training were offered prior to coronary angiography. In the control group (n = 106) standard care and information was provided without psychological support. State-anxiety was measured (scale 20-80) 1 day prior to and after coronary angiography, along with blood pressure and heart rate.


Prior to coronary angiography, state-anxiety was 54.8 +/- 11.5 (mean +/- SD) in the control group and 54.8 +/- 12.6 in the psychological support group. After coronary angiography, state-anxiety was 47.9 +/- 18.5 in the control group but 28.3 +/- 12.5 in the psychological support group (Wilcoxon rank sum test W = 7272, P < 0.001). Blood pressure was statistically significantly lower in the psychological support group prior to the intervention and the day after coronary angiography.


Psychological support including respiratory-sinus-arrhythmia biofeedback is an effective and simple tool that could be used by nurses to reduce state-anxiety and emotional stress in patients undergoing coronary angiography.

[Indexed for MEDLINE]

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