High-frequency and low-frequency heart-rate fluctuation analysis in newborns--a review of possibilities and limitations.

Respiratory sinus arrhythmia (RSA) has been traditionally defined as the high-frequency component of heart-rate fluctuations (HRF) synchronous with the respiratory movements (RM), i.e., the frequency of RSA corresponds to the respiration rate. It can be shown that at defined relations of mean heart and respiration rate some essential effects must be taken into consideration in studies using RSA parameters. The relevance of these effects is shown and a new strategy of RSA quantification demanded, at least in neonates. The diagnostic importance, physiological background and future application of the low-frequency components of the neonatal HRF are reviewed on the basis of our own results. Nonrespiratory cardiovascular HRF cannot always be detected in the neonate by power spectral analysis. Movement-related HRF have a potential diagnostic importance per se, but may also artefactually disturb the quantification of other HRF components. Long-term trends can be used to describe sleep-state related trends and their disturbances.