The Surgeon Athlete: Exercise And Its Impacts On Heart Rate Variability During Operative Cases

Heart rate variability (HRV) is a widely used biomarker to assess cardiovascular fitness and physiological flexibility under stress. While commonly monitored in athletes, HRV use in surgeons is novel. Exercise, particularly weightlifting and cardio, can improve HRV. Understanding exercise’s effects on HRV in surgeons may reveal how fitness supports physiological resilience during surgery. PURPOSE: To assess the relationship between weekly exercise minutes and HRV changes during surgery. METHODS: Surgeons across various specialties at a large midwestern academic medical center were recruited. Participants wore a heart rate monitor chest strap beneath their scrubs throughout each operation. HRV was measured as the root mean square of successive differences (RMSSD) between heart beats. Participants self-reported weekly exercise minutes, including cardio and weightlifting. RESULTS: 20 participants (13 males, 7 females) were enrolled in the surgeon athlete project. Two participants (1 male, 1 female) were excluded due to insufficient data. 11 participants exercised >150 minutes per week. HRV standard deviation across participant cases was positively correlated with weekly exercise minutes (r = 0.568, p = 0.014) and weightlifting minutes (r = 0.534, p = 0.022). The change in maximum HRV from minimum HRV positively correlated with weekly exercise minutes (r = 0.529, p = 0.024) and weightlifting minutes (r = 0.599, p = 0.009). Additionally, both minimum and maximum HRV positively correlated with weekly exercise minutes (r = 0.587, p = 0.014 and r = 0.587, p = 0.010, respectively). Total cardio exercise minutes showed a non-significant but suggestive positive correlation with participant HRV standard deviation (r = 0.402, p = 0.098). CONCLUSION: The results demonstrate that higher physical activity minutes is associated with better HRV metrics among surgeons. Weekly exercise minutes and weightlifting correlated with greater HRV variability, suggesting that fitness may enhance physiological resilience. While cardio exercise did not reach statistical significance, a trend toward increased HRV variability warrants further exploration. These findings highlight the potential role of exercise in promoting cardiovascular and stress resilience in high-demand professions like surgery.