The Heart’s Natural Pacemaker – Respiratory Sinus Arrhythmia


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Close-up of a doctor, hands only, showing a normal sinus rhythm sheet to a young female patient.
Close-up of a doctor, hands only, showing a normal sinus rhythm sheet to a young female patient.


Respiratory Sinus Arrhythmia is defined as a benign heart rate irregularity which beats in synchrony with one’s breathing. Different from other conditions of arrhythmia, this type is not considered a concern. In fact, the younger a person, the more prevalent this phenomenon is found, and the more it indicates a healthy cardiac system. In adults, however, Respiratory Sinus Arrhythmia tends to disappear, which is widely accepted as a prognostic indicator for cardiovascular disease.

An article written by a group of Japanese scientists in 1996 elaborately explains how the phenomenon of Respiratory Sinus Arrhythmia has been seen to improve pulmonary gas exchange. When a person inhales, oxygen is taken in. When one exhales, carbon dioxide is removed from the blood. This exchange of gas is found to be done more efficiently, when the phenomenon of Respiratory Sinus Arrhythmia is found more frequently in a person. Too much or too little of carbon dioxide in the blood could be taken seriously as it usually indicates a health problem. Efficient blood circulation and pulmonary gas exchange, as a result of Respiratory Sinus Arrhythmia, ensures the optimal removal of carbon dioxide in the blood.

In Cardiovascular Research, Volume 58, Issue 1, April 2003, pages 1-9, a hypothesis proposes that Respiratory Sinus Arrhythmia is an essential resting function of a cardiopulmonary system. According to scientists’ observations and detailed medical reports, if this phenomenon is found in resting animals and humans, it could minimize energy expenditure in cardiac and respiratory activities. This has been confirmed by the fact that Respiratory Sinus Arrhythmia increases during sleep, relaxation, slow and deep respiration, and reduces during high activities such as exercise and emotional state of anxiety.

A way to regain this RSA phenomenon in adults and reap the hidden benefits of it, is by practicing focused and slow breathing synchronised to the heartbeat. A review by The National Centre for Biotechnology Information (NCBI) discusses the connection between potential clinical implications of slow breathing techniques to Respiratory Sinus Arrhythmia, respiratory system, cardiovascular system and autonomic nervous systems.

NCBI recognizes that in the last decade it has seen the emergence of documents regarding the benefits of slow breathing techniques predominantly in disease states. Historically, the practice of controlling one’s breath with the purpose of restoring and/or strengthening one’s health has been around for thousands of years, especially in the Eastern cultures. With yoga entering the western world, breathing techniques have become more and more popular as interest in holistic and wellness approaches to healthcare increases.

As one grows older, the phenomenon of Respiratory Sinus Arrhythmia slowly disappears, indicating a decrease in cardiac health and gradually even in overall health. But, on the other hand, redeveloping and regaining this response can help create;

  • Physical and mental stamina,

  • Resilience to stress,

  • Better relaxation

  • A healthier and calmer nervous system

It can also reduce the risk of;

  • Asthma and other breathing issues

  • Hypertension

  • Heart Palpitations

  • Developing Atrial Fibrillation

  • Stress related illnesses

Regular practice of slow, controlled breathing, especially when synchronised to the heartbeat, brings positive physiological implications on many systems in the human body, as well as in increasing the prevalence of Respiratory Sinus Arrhythmia in adults. The latter causes efficiency in circulatory and pulmonary gas exchange, and also improves resting functions of the cardiopulmonary system. Although there is a need for further research into how slow breathing techniques is a means of optimising physiological parameters for health and longevity, key findings have included its effects on Respiratory Sinus Arrhythmia, heart rate variability, blood flow dynamics, respiratory muscle activity, ventilation efficiency and others.

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