Point:Counterpoint.

[Extract] TO THE EDITOR: In the recent Point:Counterpoint debate (2, 3), both research groups argued that training-induced bradycardia was a result of changes in intrinsic, sinoatrial node firing (i.e., intrinsic rate) or cardiac autonomic/parasympathetic regulation. While Billman (2) stated the possibility of a combination of these mechanisms, no further discussion of this was provided by either research group. Rather, the discussion focused on either mechanism and we would urge researchers to consider a more complex scenario – contribution of either mechanism that is moderated by other factors, or both mechanisms, potentially in combination with other elements (e.g., cardiac tructural changes). For example, training-induced bradycardia was reported in young adults with no changes in heart rate variability (HRV)(4), supporting an intrinsic rate mechanism. However, bradycardia was induced similarly with enhanced HRV in young adults following high-intensity exercise, supporting a cardiac autonomic mechanism (5).

[1]  G. Billman Counterpoint: Exercise training-induced bradycardia: the case for enhanced parasympathetic regulation. , 2017, Journal of applied physiology.

[2]  M. Boyett,et al.  Point: Exercise training-induced bradycardia is caused by changes in intrinsic sinus node function. , 2017, Journal of applied physiology.

[3]  G. Billman,et al.  Exercise training-induced bradycardia: evidence for enhanced parasympathetic regulation without changes in intrinsic sinoatrial node function. , 2015, Journal of applied physiology.

[4]  Shin Inada,et al.  Biophysical Characterization of the Underappreciated and Important Relationship Between Heart Rate Variability and Heart Rate , 2014, Hypertension.

[5]  T. Allison,et al.  Sport Modality Affects Bradycardia Level and Its Mechanisms of Control in Professional Athletes , 2014, International Journal of Sports Medicine.

[6]  U. Wisløff,et al.  Exercise training reduces resting heart rate via downregulation of the funny channel HCN4 , 2014, Nature Communications.

[7]  E. D. Larson,et al.  Depressed pacemaker activity of sinoatrial node myocytes contributes to the age-dependent decline in maximum heart rate , 2013, Proceedings of the National Academy of Sciences.

[8]  Henggui Zhang,et al.  Commentaries on Viewpoint: Is the resting bradycardia in athletes the result of remodeling of the sinoatrial node rather than high vagal tone? , 2013, Journal of applied physiology.

[9]  Paul D. Bromley,et al.  Effects of exercise on heart rate variability: inferences from meta-analysis. , 2005, Medicine and science in sports and exercise.

[10]  J. Goodman,et al.  Left ventricular adaptations following short-term endurance training. , 2005, Journal of applied physiology.

[11]  A. Leicht,et al.  Influence of intensive cycling training on heart rate variability during rest and exercise. , 2003, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[12]  A. Leicht,et al.  Influence of age and moderate-intensity exercise training on heart rate variability in young and mature adults. , 2003, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[13]  J R Stratton,et al.  Effect of endurance exercise training on heart rate variability at rest in healthy young and older men. , 1998, The American journal of cardiology.

[14]  A Maillet,et al.  Reduced spontaneous baroreflex response slope during lower body negative pressure after 28 days of head-down bed rest. , 1994, Journal of applied physiology.

[15]  A P Blaber,et al.  Effect of 28-day head-down bed rest with countermeasures on heart rate variability during LBNP. , 1994, Aviation, space, and environmental medicine.

[16]  P. Raven,et al.  Exercise training bradycardia: the role of autonomic balance. , 1989, Medicine and science in sports and exercise.

[17]  A. Guz,et al.  Sympathetic and parasympathetic cardiac control in athletes and nonathletes at rest. , 1982, Journal of applied physiology: respiratory, environmental and exercise physiology.

[18]  E. Nylander,et al.  Non-autonomic component in bradycardia of endurance trained men at rest and during exercise. , 1980, Acta physiologica Scandinavica.

[19]  R. Hughson,et al.  Reduction of intrinsic sinoatrial frequency and norepinephrine response of the exercised rat. , 1977, Canadian journal of physiology and pharmacology.

[20]  J. Sutton,et al.  Control of heart-rate in healthy young men. , 1967, Lancet.

[21]  A. Aubert,et al.  Heart Rate Variability in Athletes , 2003, Sports medicine.