--- title: "The impact of visit-to-visit heart rate variability on all-cause…" description: "Both very low and very high heart rate variability between doctor visits are linked to a higher risk of death in people with atrial fibrillation." url: "https://magellanlongevity.com/study/hrv.md" canonical: "https://magellanlongevity.com/study/hrv.html" html: "https://magellanlongevity.com/study/hrv.html" type: "study" study_key: "hrv" journal: "Annals of Noninvasive Electrocardiology" year: 2024 pmid: "38288511" doi: "10.1111/anec.13094" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # The impact of visit-to-visit heart rate variability on all-cause mortality [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › The impact of visit-to-visit heart rate variability on… **HTML version:** https://magellanlongevity.com/study/hrv.html · **In the Magellan app:** https://magellanlongevity.com/#/study/hrv ## Citation | Field | Value | | --- | --- | | Journal | Annals of Noninvasive Electrocardiology | | Year | 2024 | | PMID | [38288511](https://pubmed.ncbi.nlm.nih.gov/38288511/) | | DOI | [10.1111/anec.13094](https://doi.org/10.1111/anec.13094) | | Study key | hrv | ## Takeaway Both very low and very high heart rate variability between doctor visits are linked to a higher risk of death in people with atrial fibrillation. ## The question What is the association between visit-to-visit heart rate variability (VVHRV) and all-cause mortality in patients with atrial fibrillation (AF)? ## Hypothesis The relationship between VVHRV and the prognosis of AF is uncertain, but previous studies suggest a correlation between VVHRV and adverse outcomes. ## Methods The study examined 3983 participants with AF from the AFFIRM study. VVHRV was measured using the standard deviation of heart rate (HRSD), and patients were divided into four quartiles based on HRSD. Cox proportional hazard regressions were used to estimate hazard ratios for all-cause mortality. ## Results During an average follow-up of 3.5 years, 621 participants died. Both the lowest and highest quartiles of HRSD independently predicted an increased risk of all-cause mortality compared to the second and third quartiles, showing a U-shaped relationship. Specifically, the 1st quartile had hazard ratios of 2.28 (vs 2nd) and 2.23 (vs 3rd), while the 4th quartile had hazard ratios of 1.82 (vs 2nd) and 1.78 (vs 3rd). ## Conclusion In patients with AF, both lower and higher visit-to-visit heart rate variability are associated with an increased risk of all-cause mortality, forming a U-shaped curve. ## Limitations The abstract does not explicitly state any limitations of the study. ## Verbatim from the abstract > Previous studies have shown a positive correlation between heart rate variability and clinical outcomes, including all-cause mortality. ## Hazard Ratios for All-Cause Mortality by HRSD Quartile in AF Patients | Measure | Hazard Ratio | | --- | --- | | 1st vs 2nd Quartile | 2.28 | | 1st vs 3rd Quartile | 2.23 | | 4th vs 2nd Quartile | 1.82 | | 4th vs 3rd Quartile | 1.78 | *Hazard ratios for all-cause mortality comparing the lowest (1st) and highest (4th) quartiles of HRSD to the middle (2nd and 3rd) quartiles.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Comprehensive Blood-Biomarker Testing | — | — | | Biometric Wearables (Sleep, HRV & Recovery) | Measurement tool | [Garmin Forerunner 265](https://magellanlongevity.com/p/65.md), [Oura Ring Gen 4](https://magellanlongevity.com/p/61.md), [Apple Watch Series 11](https://magellanlongevity.com/p/63.md) | | Heart-Rate-Variability & Autonomic Tools | — | — | | Neurofeedback & Stress-Resilience Devices | — | — | | Optical Biomarker Scanning | — | — | | Smart Body-Composition Analysis | Measurement tool | [Withings Body Scan Scale](https://magellanlongevity.com/p/77.md) | ## Reference 1. **The impact of visit-to-visit heart rate variability on all-cause mortality** Annals of Noninvasive Electrocardiology 2024 · [PMID 38288511](https://pubmed.ncbi.nlm.nih.gov/38288511/) · [DOI 10.1111/anec.13094](https://doi.org/10.1111/anec.13094) > Previous studies have shown a positive correlation between heart rate variability and clinical outcomes, including all-cause mortality. ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/hrv.html#page","url":"https://magellanlongevity.com/study/hrv.html","name":"The impact of visit-to-visit heart rate variability on all-cause mortality","description":"Both very low and very high heart rate variability between doctor visits are linked to a higher risk of death in people with atrial fibrillation.","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/hrv.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"The impact of visit-to-visit heart rate variability on…","item":"https://magellanlongevity.com/study/hrv.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/hrv.html#study","name":"The impact of visit-to-visit heart rate variability on all-cause mortality","headline":"The impact of visit-to-visit heart rate variability on all-cause mortality","datePublished":"2024","isPartOf":{"@type":"Periodical","name":"Annals of Noninvasive Electrocardiology"},"identifier":"PMID:38288511","url":"https://pubmed.ncbi.nlm.nih.gov/38288511/","sameAs":"https://doi.org/10.1111/anec.13094","abstract":"Both very low and very high heart rate variability between doctor visits are linked to a higher risk of death in people with atrial fibrillation."}]} ``` ## Related on Magellan Longevity - [Garmin Forerunner 265](https://magellanlongevity.com/p/65.md) — product graded on this and related evidence - [Oura Ring Gen 4](https://magellanlongevity.com/p/61.md) — product graded on this and related evidence - [Apple Watch Series 11](https://magellanlongevity.com/p/63.md) — product graded on this and related evidence - [WHOOP Band 5.0](https://magellanlongevity.com/p/62.md) — product graded on this and related evidence - [An epigenetic biomarker of aging for lifespan and healthspan](https://magellanlongevity.com/study/epigenetic_clock.md) - [DNA methylation GrimAge strongly predicts lifespan and healthspan](https://magellanlongevity.com/study/x10.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).