Method & Application
he HRV testing provided by Intellewave allows the physician to identify the state of the patient's autonomic balance with the corresponding activity of the sympathetic and parasympathetic branches of the autonomic nervous system (ANS). These tests are reimbursed according to CPT codes and can be linked to various ICD-9 diagnoses. However, from the scientific point of view, application of the device is not limited by its diagnostic capabilities: Intellewave is a physiologic device providing an in-depth, comprehensive physiological assessment of the patient, which is often missing in standard medical practice.
Heart rate variability, or variations of beat-to-beat intervals in length, is regulated by both sympathetic and parasympathetic branches of the autonomic nervous system. Intellewave uses power spectral analysis for quantitative assessment of Heart Rate Variability and presents the results in the chart shown on the right. The system measures interrelation of the two most significant components of HRV analysis - intensities of high frequency (HF) variations and intensities of low frequency (LF) variations and displays them on the Cartesian system of coordinates. Numerous research studies demonstrated the high correlation of HF intensity with an activity of the parasympathetic system, and the LF intensity with a mixture of various regulatory inputs, including sympathetic and partial parasympathetic inputs as well as the activity of baroreceptors, mechanisms of thermoregulation, hormonal control, and other neurohumoral mechanisms. In HRV testing the HF intensity parameter serves primarily as a tool for assessing parasympathetic activity. The graph displays the LF intensity (reference - sympathetic activity) on the vertical axis while the HF intensity (reference - Parasympathetic activity) is on the horizontal axis.
Traditionally the ANS is regarded in terms of its structure and its function. The structural components are the sympathetic and parasympathetic branches while the functional aspect is illustrated by a list of disorders, collectively known as dysautonomia. The HRV analysis provided by the Intellewave system rises on a higher level by treating structure and function simultaneously - it detects up to 81 distinctive relationships between sympathetic and parasympathetic systems that correspond to 81 states of physiological functioning.
The Intellewave system can be used for patient testing during initial assessment or at any stage of the treatment. Any medical intervention immediately triggers a reaction of the ANS, and with HRV testing a physician can monitor this reaction. Functioning of both branches of the ANS is regulated by input from all internal structures and mechanisms of the body, which broadens the scope of application of HRV testing: it can be used for a wide range of conditions starting from psychiatric disorders to pathologies of internal organs. The testing thus provides the physician with a highly reliable feedback for any treatment and helps to optimize the treatment strategy in virtually all areas of medicine.
The system allows the physician to investigate 3 modalities:
- Orthostatic intervention (lying-to-standing test)
- Valsalva maneuver combined with deep breathing
- Real-Time HRV assessment (1 or 2 channels)
Please note that the HRV assessment should not be used as the only basis for a specific clinical diagnosis or treatment. The results of the HRV analysis should be combined with other clinical data. In this combination, the physicians can verify that assessment provided by the HRV analysis highly correlates with assessment obtained via other clinical diagnostic methods.