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Published in: BMC Sports Science, Medicine and Rehabilitation 1/2018

Open Access 01-12-2018 | Research article

Wrist-worn optical and chest strap heart rate comparison in a heterogeneous sample of healthy individuals and in coronary artery disease patients

Authors: Francesco Sartor, Jos Gelissen, Ralph van Dinther, David Roovers, Gabriele B. Papini, Giuseppe Coppola

Published in: BMC Sports Science, Medicine and Rehabilitation | Issue 1/2018

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Abstract

Background

The need for unobtrusive HR (heart rate) monitoring has led to the development of a new generation of strapless HR monitors. The aim of this study was to determine whether such an unobtrusive, wrist-worn optical HR monitor (OHRM) could be equivalent and therefore a valid alternative to a traditional chest strap during a broad range of activities in a heterogeneous healthy population and coronary artery disease (CAD) patients.

Methods

One hundred ninety-nine healthy volunteers, 84 males and 115 females, including 35 overweight-obese subjects, 53 pregnant women, and 20 CAD patients were tested in the present study. Second-by-second HR measured by the OHRM was concurrently evaluated against an ECG-based chest strap monitor during a broad range of activities (i.e., walking, running, cycling, gym, household, and sedentary activities).

Results

Data coverage, percentage of time the OHRM provides a HR not larger than 10 bpm from the reference, went from a minimum of 92% of the time in the least periodic activity (i.e., gym), to 95% during the most intense activity (i.e., running), and to a maximum of 98% for sedentary activities. The limits of agreement of the difference between the OHRM and the chest strap HR were within the range of ±15 bpm. The OHRM showed a concordance correlation coefficient of 0.98. Overall, the mean absolute error was not larger than 3 bpm, which can be considered clinically acceptable for a number of applications. A similar performance was found for CAD (94.2% coverage, 2.4 bpm error), but the small sample size does not allow any quantitative comparison.

Conclusion

Heart rate measured by OHRM at the wrist and ECG-based HR measured via a traditional chest strap are acceptably close in a broad range of activities in a heterogeneous, healthy population, and showed initial promising results also in CAD patients.
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Literature
1.
go back to reference Keith A, Flack M. The form and nature of the muscular connections between the primary divisions of the vertebrate heart. J Anat Physiol. 1907;41(Pt 3):172–89.PubMedPubMedCentral Keith A, Flack M. The form and nature of the muscular connections between the primary divisions of the vertebrate heart. J Anat Physiol. 1907;41(Pt 3):172–89.PubMedPubMedCentral
3.
go back to reference Abboud FM, Thames MD. Interaction of cardiovascular reflexes in circulatory control. In: Pollock DM, editor. Comprehensive physiology. Chichester: Wiley-Blackwell; 1983. p. 675–753. Abboud FM, Thames MD. Interaction of cardiovascular reflexes in circulatory control. In: Pollock DM, editor. Comprehensive physiology. Chichester: Wiley-Blackwell; 1983. p. 675–753.
4.
go back to reference Fick AE, editor. On the measurement of the blood quantity in the ventricles of the heart. Wurzburg: Physiological, Medical Society; 1870. Fick AE, editor. On the measurement of the blood quantity in the ventricles of the heart. Wurzburg: Physiological, Medical Society; 1870.
5.
go back to reference Sartor F, Vernillo G, de Morree HM, Bonomi AG, La Torre A, Kubis HP, et al. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings. Sports Med. 2013;43(9):865–73.CrossRefPubMed Sartor F, Vernillo G, de Morree HM, Bonomi AG, La Torre A, Kubis HP, et al. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings. Sports Med. 2013;43(9):865–73.CrossRefPubMed
6.
go back to reference Achten J, Jeukendrup AE. Heart rate monitoring: applications and limitations. Sports Med. 2003;33(7):517–38.CrossRefPubMed Achten J, Jeukendrup AE. Heart rate monitoring: applications and limitations. Sports Med. 2003;33(7):517–38.CrossRefPubMed
7.
go back to reference Spierer DK, Rosen Z, Litman LL, Fujii K. Validation of photoplethysmography as a method to detect heart rate during rest and exercise. J Med Eng Technol. 2015;39(5):264–71.CrossRefPubMed Spierer DK, Rosen Z, Litman LL, Fujii K. Validation of photoplethysmography as a method to detect heart rate during rest and exercise. J Med Eng Technol. 2015;39(5):264–71.CrossRefPubMed
8.
go back to reference Wang R, Blackburn G, Desai M, Phelan D, Gillinov L, Houghtaling P, et al. Accuracy of wrist-worn heart rate monitors. JAMA Cardiol. 2016;2(1):104–6.CrossRef Wang R, Blackburn G, Desai M, Phelan D, Gillinov L, Houghtaling P, et al. Accuracy of wrist-worn heart rate monitors. JAMA Cardiol. 2016;2(1):104–6.CrossRef
9.
go back to reference Weippert M, Kumar M, Kreuzfeld S, Arndt D, Rieger A, Stoll R. Comparison of three mobile devices for measuring R-R intervals and heart rate variability: polar S810i, Suunto t6 and an ambulatory ECG system. Eur J Appl Physiol. 2010;109(4):779–86.CrossRefPubMed Weippert M, Kumar M, Kreuzfeld S, Arndt D, Rieger A, Stoll R. Comparison of three mobile devices for measuring R-R intervals and heart rate variability: polar S810i, Suunto t6 and an ambulatory ECG system. Eur J Appl Physiol. 2010;109(4):779–86.CrossRefPubMed
10.
go back to reference Kingsley M, Lewis MJ, Marson RE. Comparison of polar 810s and an ambulatory ECG system for RR interval measurement during progressive exercise. Int J Sports Med. 2005;26(1):39–44.CrossRefPubMed Kingsley M, Lewis MJ, Marson RE. Comparison of polar 810s and an ambulatory ECG system for RR interval measurement during progressive exercise. Int J Sports Med. 2005;26(1):39–44.CrossRefPubMed
11.
go back to reference Laukkanen RM, Virtanen PK. Heart rate monitors: state of the art. J Sports Sci. 1998;16(Suppl):S3–7.CrossRefPubMed Laukkanen RM, Virtanen PK. Heart rate monitors: state of the art. J Sports Sci. 1998;16(Suppl):S3–7.CrossRefPubMed
13.
go back to reference Parak J, Korhonen I. Evaluation of wearable consumer heart rate monitors based on photopletysmography. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. 2014;2014:3670–3673. Parak J, Korhonen I. Evaluation of wearable consumer heart rate monitors based on photopletysmography. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. 2014;2014:3670–3673.
14.
go back to reference Andre D, Wolf DL. Recent advances in free-living physical activity monitoring: a review. J Diab Sci Technol. 2007;1(5):760–7.CrossRef Andre D, Wolf DL. Recent advances in free-living physical activity monitoring: a review. J Diab Sci Technol. 2007;1(5):760–7.CrossRef
15.
go back to reference Valenti G, Westerterp KR. Optical heart rate monitoring module validation study. Ieee Icce. 2013:195–6. Valenti G, Westerterp KR. Optical heart rate monitoring module validation study. Ieee Icce. 2013:195–6.
16.
go back to reference Allen J. Photoplethysmography and its application in clinical physiological measurement. Physiol Meas. 2007;28(3):R1–39.CrossRefPubMed Allen J. Photoplethysmography and its application in clinical physiological measurement. Physiol Meas. 2007;28(3):R1–39.CrossRefPubMed
17.
go back to reference Wijshoff R, Mischi M, Aarts R. Reduction of periodic motion artifacts in photoplethysmography. IEEE Trans Biomed Eng. 2016;64(1):196–207.CrossRefPubMed Wijshoff R, Mischi M, Aarts R. Reduction of periodic motion artifacts in photoplethysmography. IEEE Trans Biomed Eng. 2016;64(1):196–207.CrossRefPubMed
18.
go back to reference Maeda Y, Sekine M, Tamura T. Relationship between measurement site and motion artifacts in wearable reflected Photoplethysmography. J Med Syst. 2011;35(5):969–76.CrossRefPubMed Maeda Y, Sekine M, Tamura T. Relationship between measurement site and motion artifacts in wearable reflected Photoplethysmography. J Med Syst. 2011;35(5):969–76.CrossRefPubMed
19.
go back to reference Sperlich B, Holmberg HC. Wearable, yes, but able...?: it is time for evidence-based marketing claims! Br J Sports Med. 2017;51(16):1240.CrossRefPubMed Sperlich B, Holmberg HC. Wearable, yes, but able...?: it is time for evidence-based marketing claims! Br J Sports Med. 2017;51(16):1240.CrossRefPubMed
20.
go back to reference Robergs RA, Landwehr R. The surprising history of the HRmax=220-age equation. J Exerc Physiol Online. 2002;5(2):1–10. Robergs RA, Landwehr R. The surprising history of the HRmax=220-age equation. J Exerc Physiol Online. 2002;5(2):1–10.
21.
go back to reference Sneed NV, Hollerbach AD. Accuracy of heart rate assessment in atrial fibrillation. Heart Lung. 1992;21(5):427–33.PubMed Sneed NV, Hollerbach AD. Accuracy of heart rate assessment in atrial fibrillation. Heart Lung. 1992;21(5):427–33.PubMed
22.
go back to reference ANSI/AAMI. Cardiac monitors, heart rate meters, and alarms. Arlington: American National Standards Institute, Inc.; 2002. ANSI/AAMI. Cardiac monitors, heart rate meters, and alarms. Arlington: American National Standards Institute, Inc.; 2002.
23.
go back to reference Delgado-Gonzalo R, Parak J, Tarniceriu A, Renevey P, Bertschi M, Korhonen I. Evaluation of accuracy and reliability of PulseOn optical heart rate monitoring device. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. 2015;2015:430–3. Delgado-Gonzalo R, Parak J, Tarniceriu A, Renevey P, Bertschi M, Korhonen I. Evaluation of accuracy and reliability of PulseOn optical heart rate monitoring device. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. 2015;2015:430–3.
24.
go back to reference Wallen MP, Gomersall SR, Keating SE, Wisloff U, Coombes JS. Accuracy of heart rate watches: implications for weight management. PLoS One. 2016;11(5):e0154420.CrossRefPubMedPubMedCentral Wallen MP, Gomersall SR, Keating SE, Wisloff U, Coombes JS. Accuracy of heart rate watches: implications for weight management. PLoS One. 2016;11(5):e0154420.CrossRefPubMedPubMedCentral
25.
go back to reference Gillinov S, Etiwy M, Wang R, Blackburn G, Phelan D, Gillinov AM, et al. Variable accuracy of wearable heart rate monitors during aerobic exercise. Med Sci Sports Exerc. 2017;49(8):1697–703.CrossRefPubMed Gillinov S, Etiwy M, Wang R, Blackburn G, Phelan D, Gillinov AM, et al. Variable accuracy of wearable heart rate monitors during aerobic exercise. Med Sci Sports Exerc. 2017;49(8):1697–703.CrossRefPubMed
26.
go back to reference Cadmus-Bertram L, Gangnon R, Wirkus EJ, Thraen-Borowski KM, Gorzelitz-Liebhauser J. The accuracy of heart rate monitoring by some wrist-worn activity trackers. Ann Intern Med. 2017;166(8):610–2.CrossRefPubMedPubMedCentral Cadmus-Bertram L, Gangnon R, Wirkus EJ, Thraen-Borowski KM, Gorzelitz-Liebhauser J. The accuracy of heart rate monitoring by some wrist-worn activity trackers. Ann Intern Med. 2017;166(8):610–2.CrossRefPubMedPubMedCentral
27.
go back to reference Coppetti T, Brauchlin A, Muggler S, Attinger-Toller A, Templin C, Schonrath F, et al. Accuracy of smartphone apps for heart rate measurement. Eur J Prev Cardiol. 2017;24(12):1287–93.CrossRefPubMed Coppetti T, Brauchlin A, Muggler S, Attinger-Toller A, Templin C, Schonrath F, et al. Accuracy of smartphone apps for heart rate measurement. Eur J Prev Cardiol. 2017;24(12):1287–93.CrossRefPubMed
28.
go back to reference Kroll RR, Boyd JG, Maslove DM. Accuracy of a wrist-worn wearable device for monitoring heart rates in hospital inpatients: a prospective observational study. J Med Internet Res. 2016;18(9):e253.CrossRefPubMedPubMedCentral Kroll RR, Boyd JG, Maslove DM. Accuracy of a wrist-worn wearable device for monitoring heart rates in hospital inpatients: a prospective observational study. J Med Internet Res. 2016;18(9):e253.CrossRefPubMedPubMedCentral
29.
go back to reference American College of Sports Medicine. ACSM’s resource manual for guidelines for exercise testing and prescription, vol. 304. 6th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. p. 453. American College of Sports Medicine. ACSM’s resource manual for guidelines for exercise testing and prescription, vol. 304. 6th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. p. 453.
30.
go back to reference Zavorsky GS, Longo LD. Exercise guidelines in pregnancy: new perspectives. Sports Med. 2011;41(5):345–60.CrossRefPubMed Zavorsky GS, Longo LD. Exercise guidelines in pregnancy: new perspectives. Sports Med. 2011;41(5):345–60.CrossRefPubMed
31.
go back to reference Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315–81.CrossRefPubMedPubMedCentral Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315–81.CrossRefPubMedPubMedCentral
32.
go back to reference Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869–71.CrossRefPubMed Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869–71.CrossRefPubMed
33.
go back to reference Han H, Kim J. Artifacts in wearable photoplethysmographs during daily life motions and their reduction with least mean square based active noise cancellation method. Comput Biol Med. 2012;42(4):387–93.CrossRefPubMed Han H, Kim J. Artifacts in wearable photoplethysmographs during daily life motions and their reduction with least mean square based active noise cancellation method. Comput Biol Med. 2012;42(4):387–93.CrossRefPubMed
34.
go back to reference Cumming GR, Glenn J. Evaluation of the Canadian home fitness test in middle-aged men. Can Med Assoc J. 1977;117(10):1138.PubMedPubMedCentral Cumming GR, Glenn J. Evaluation of the Canadian home fitness test in middle-aged men. Can Med Assoc J. 1977;117(10):1138.PubMedPubMedCentral
35.
go back to reference Bonomi AG, Schipper F, Eerikäinen LM, Margarito J, Aarts RM, Babaeizadeh S, et al. Atrial fibrillation detection using photo-plethysmography and acceleration data at the wrist. In: IEEE Engineering in Medicine and Biology Society, editor. Computing in cardiology; 2016 Sep 11–14; Vancouver (Canada) 2016. Bonomi AG, Schipper F, Eerikäinen LM, Margarito J, Aarts RM, Babaeizadeh S, et al. Atrial fibrillation detection using photo-plethysmography and acceleration data at the wrist. In: IEEE Engineering in Medicine and Biology Society, editor. Computing in cardiology; 2016 Sep 11–14; Vancouver (Canada) 2016.
Metadata
Title
Wrist-worn optical and chest strap heart rate comparison in a heterogeneous sample of healthy individuals and in coronary artery disease patients
Authors
Francesco Sartor
Jos Gelissen
Ralph van Dinther
David Roovers
Gabriele B. Papini
Giuseppe Coppola
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Sports Science, Medicine and Rehabilitation / Issue 1/2018
Electronic ISSN: 2052-1847
DOI
https://doi.org/10.1186/s13102-018-0098-0

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