Meeus, Mira, Goubert, Dorien, De Backer, Fien et al. · Seminars in arthritis and rheumatism · 2013 · DOI
This review looked at 16 studies comparing heart rhythm patterns between people with fibromyalgia, chronic fatigue syndrome, and healthy controls. Both conditions showed changes in how the heart responds to stress, but the patterns were different: fibromyalgia patients had heart rhythm problems throughout the day, while CFS patients mainly showed them during sleep. Exercise helped improve heart rhythm patterns in fibromyalgia patients.
Understanding autonomic nervous system dysfunction in ME/CFS is crucial for explaining symptoms like heart palpitations, orthostatic intolerance, and abnormal stress responses. This review reveals that ME/CFS and fibromyalgia have different patterns of autonomic dysfunction, suggesting they may involve different physiological mechanisms—an important distinction for developing targeted treatments.
This review cannot establish whether autonomic dysfunction causes ME/CFS symptoms or is a consequence of the illness. It also does not prove that the autonomic changes are specific to these conditions rather than secondary to pain, deconditioning, or other factors. Direct comparative studies between FM and CFS are needed to confirm the differences observed.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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