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Research Library

Comparison of the Effects of Islamic Spiritual Educations and Breathing Techniques with Heart Rate Variability Feedback Therapies on Heart Rate Variability, Psychophysiological Coordination and Stress in Patients Undergoing Coronary Artery Bypass Graft Surgery

    • Published: 2019
    • Hadi Bahrami Ehsan1, Siamak Vahedi2, Mohiadin Amjadian3, Reza Rostami1, and Kaivan Saboni4
    • Shiraz E-Med J. 2019 August; 20(8):e83485. DOI: 10.5812/semj.83485.1. Psychology Department, Tehran University, Tehran, Iran. 2. Cardiology Department, Kurdistan Medical Sciences University, Sanadaj, Iran. 3. Clinical Psychology Department, Kurdistan Medical Sciences University, Sanandaj, Iran. 4. Surgery Department, Kurdistan Medical Sciences University, Sanandaj, Iran.
    • Download the complete paper, click here.



Patients with coronary artery disease also have psychological disorders, such as stress and depression, especially if they underwent coronary artery bypass graft (CABG) surgery; a type of bypass surgery that forms new routes around narrowed and blocked coronary arteries, permitting increased blood flow to deliver oxygen and nutrients to the heart muscle.


The current study aimed at comparing the effect of Islamic educations and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV, psychophysiological coordination, and stress in patients undergoing CABG.


A total of 60 patients who underwent CABG surgery were selected and randomly assigned to three equal groups of the Islamic educations, breathing techniques, and control. The experimental groups received an eight-week intervention as a two-hour session per week with home practices. The control group received only the routine hospital care. The stress, HRV, and psychophysiological coordination levels of the subjects were evaluated before and after the interventions in the three groups using depression, anxiety, and stress scale-21 for stress and emWave Desktop software for HRV and psychophysiological coordination. The data were analyzed using ANCOVA and descriptive tests with SPSS version 21.


The results showed a significant difference among the three groups in the increase of HRV and psychophysiological coordination and decrease of stress. Moreover, stress level reduced more in the Islamic educations group, while HRV and psychophysiological coordination levels increased more in the breathing techniques group.


Based on the results, it is recommended using both Islamic educations and breathing techniques as well as HRV biofeedback therapies in rehabilitation programs for patients undergoing CABG in hospitals.