SPECIAL ISSUE: Improve Client Care by Dispelling HRV Myths
Heart rate variability (HRV) indexes how efficiently we mobilize and utilize limited self-regulatory resources to maintain homeostasis. HRV plays a vital role in regulatory capacity, executive functions, health, and performance. We address common misconceptions regarding cardiovascular health, HRV measurement, and HRV biofeedback training. This review highlights the importance of context and individual differences in interpreting HRV. We debunk common misconceptions to improve HRV biofeedback training for health and performance.

The “variability is bad, stability is good” myth. Real Genius episode by Dani S at Fiverr.com.

Healthy variability. Graphic by minaanandag at Fiverr.com.

Low variability. Graphic by minaanandag at Fiverr.com.

A healthy heart is not a metronome. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

Tilt table graphic © Pepermpron/Shutterstock.com.

Three main parasympathetic HRV sources. Graphic created by authors.

The “sympathetic activity plays a major role in HRV” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

BioGraph Infiniti screenshot of RSA by authors. The upper waveform is respiration, and the lower is instantaneous HR.

The heartbeats are closer together during inhalation and further apart during exhalation. Illustration by minaanandag at Fiver.com.

HR speeds during inhalation. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

HR slows during exhalation. Graphic by Dani S. at Fiverr.com.

Two-closed-loop model drawn by authors.

Arteriole graphic © Ali DM/Shutterstock.com.

The “VLF power increases during HRVB training are sympathetic” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The “LF power and the LF/HF ratio are sympathetic” myth. HRV frequency graphic adapted from Dr. Richard Gevirtz by Dani S at Fiverr.com.

The “we should measure HF power during SPB” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The “we can directly compare HRV recordings of different lengths” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The “you should trust smartphone HRV app values” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The “try to relax” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The “successful HRVB training always produces a 0.1-Hz LF peak” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The “when SPB increases HR oscillations, this signals greater vagal tone” myth. Graphic adapted from Gevirtz et al. (2016) by Dani S at Fiverr.com.

The “the best sign of HRV training success is high resting LF power” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

The spectral plots are courtesy of Dr. Inna Khazan. HF power increases from pretraining to posttraining baselines.

The “HRVB asks clients to slow their daily breathing permanently” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.

Curling graphic © ra2 studio/Shutterstock.com.

The “SPB is the best way to increase HRV” myth. Real Genius episode on WEBTOON by Dani S at Fiverr.com.


Contributor Notes