Redefining respiratory sinus arrhythmia as respiratory heart rate variability: an international Expert Recommendation for terminological clarity.
Level 5 - mechanism / opinion, no new human data
Expert consensus recommendation proposing terminology change with no primary human data or systematic review methodology.
PubMed 40328963 · doi:10.1038/s41569-025-01160-z
What was done
An international panel of experts evaluated the terminology, physiological mechanisms, and interpretation of respiratory-driven heart rate fluctuations to formulate an Expert Recommendation on standard nomenclature.
What was found
The abstract reports no empirical data or quantitative metrics. The authors argue that the traditional label 'respiratory sinus arrhythmia' (RSA) carries misleading pathological connotations despite describing a normal physiological phenomenon. They recommend adopting the term 'respiratory heart rate variability' (RespHRV), clarify that RespHRV spans both low-frequency and high-frequency spectral bands depending on breathing rate, and emphasize that RespHRV amplitude should not be equated directly with cardiac vagal tone.
Why it matters
Adopting clearer terminology prevents the misinterpretation of a normal physiological process as a cardiac arrhythmia and promotes more accurate physiological interpretation in autonomic and cardiovascular research.
Limits
This publication is an expert recommendation and conceptual review without primary experimental data, prospective validation, or systematic review methodology. The practical adoption and utility of the proposed nomenclature across clinical and research fields remain to be demonstrated.
Cited by
- supports Heart rate speeds up slightly during inhalation and slows down during exhalation via respiratory sinus arrhythmia mediated by the vagus nerve.