Separation of sympathetic and parasympathetic nervous control of heart rate variability using principal dynamic modes

This work introduces a modified principal dynamic modes (POM) method, which for the first time is able to separate the dynamics of sympathetic and parasympathetic nervous activities. The PDM is based on the principle that among all possible choices of expansion bases, there are some that require the minimum number of basis functions to achieve a given mean-square approximation of the system output. Such a minimum set of basis functions is termed PDMs of the nonlinear system. We found that the first two dominant PDMs have similar frequency characteristics for parasympathetic and sympathetic activities, as reported in the literature. These results are consistent for all nine of our healthy human subjects using our modified PDM approach. Validation of the purported separation of parasympathetic and sympathetic activities was performed by the application of the autonomic nervous system blocking drugs atropine and propranolol. With separate applications of the respective drugs, we found a significant decrease in the amplitude of the waveforms that correspond to each nervous activity. Furthermore, we observed near complete elimination of these dynamics when both drugs were given to the subjects. Comparison of our method to the conventional low/high frequency ratio shows that our proposed approach provides more accurate assessment of the autonomic nervous balance. Our nonlinear PDM approach allows for the first time, a clear separation of the two autonomic nervous activities, the lack of which has been the main reason why heart rate variability analysis has not had wide clinical acceptance.