Comparison of Heart Rate Variability Signal Features Derived from Electrocardiography and Photoplethysmography in Healthy Individuals

The heart rate variability (HRV) signal is indicative of autonomic regulation of the heart rate (HR). It could be used as a noninvasive marker in monitoring the physiological state of an individual. Currently, the primary method of deriving the HRV signal is to acquire the electrocardiogram (ECG) signal, apply appropriate QRS detection algorithms to locate the R wave and its peak, find the RR intervals, and perform suitable interpolation and resampling to produce a uniformly sampled tachogram. This process could sometimes result in errors in the HRV signal due to drift, electromagnetic and biologic interference, and the complex morphology of the ECG signal. The photoplethysmographic (PPG) signal has the potential to eliminate the problems with the ECG signal to derive the HRV signal. To investigate this point, a PDA-based system was developed to simultaneously record ECG and PPG signals to facilitate accurately controlled sampling and recording durations. Two healthy young volunteers participated in this pilot study to evaluate the applicability of our approach. To improve data quality, ECG and PPG recordings were acquired three times/subject. A comparison between different features of the HRV signals derived from both methods was performed to test the validity of using PPG signals in HRV analysis. We used autoregressive (AR) modeling, Poincare' plots, cross correlation, standard deviation, arithmetic mean, skewness, kurtosis, and approximate entropy (ApEn) to derive and compare different measures from both ECG and PPG signals. This study demonstrated that our PDA-based system was a convenient and reliable means for acquisition of PPG-derived and ECG-derived HRV signals. The excellent agreement between different measures of HRV signals acquired from both methods provides potential support for the idea of using PPGs instead of ECGs in HRV signal derivation and analysis in ambulatory cardiac monitoring of healthy individuals.