Closed-Loop Neurofeedback Targeting the Left Dorsolateral Prefrontal Cortex for Cardiac Autonomic Modulation in Coronary Artery Disease With Anxiety

Inclusion Criteria: * Age \>18 years, any sex. * Right-handed, with resting heart rate between 60 and 100 beats per minute. * Confirmed diagnosis of CHD, defined as at least one of the following: (i) positive stress test; (ii) documented myocardial infarction (MI) with electrocardiographic changes and concurrent elevation of creatine kinase MB isoenzyme or troponin; (iii) angiographically confirmed coronary atherosclerosis with ≥50% stenosis in at least one coronary artery. * Diagnosis of an anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). * Hamilton Anxiety Rating Scale (HAMA) score ≥16 and 17-item Hamilton Depression Rating Scale (HAMD-17) score ≤17. Exclusion Criteria: * Acute unstable angina. * Severe congestive heart failure (New York Heart Association \[NYHA\] class IV). * Valvular heart disease. * History of atrial fibrillation. * Unstable blood pressure, defined as systolic blood pressure \>180 mmHg or \<90 mmHg. * Pregnancy. * History of unstable medical conditions, including cerebrovascular disease, dementia, hyperthyroidism, pulmonary disease, or malignancy. These are assessed through medical history, electronic health records, physical examination, and ECG findings. * High risk of suicide or homicide. * Presence of other psychiatric disorders, including psychotic disorders, bipolar disorder, or active substance use disorders. * Use of psychotropic medication within 1 month prior to enrolment, to avoid potential interference with haemodynamic measurements.