Abstract

Abstract Introduction A sheet-type device beneath the mattress was developed for non-invasive monitoring of cardiac rhythm during sleep and in bedridden end-of-life elderly patients, enabling the acquisition of ballistocardiography (BCG) signals. BCG represents minute vibrations in the body associated with cardiac ejection of blood and has recently been utilized to estimate heart rate variability (HRV) indices. This study aimed to compare HRV indices derived from BCG with those obtained from simultaneously measured electrocardiogram (ECG) and assess their agreement. Methods Healthy subjects (14 males, 11 females; age 40.6±12.8 yrs.) were recruited between August 2022 and April 2023. Subjects laid on a bed with the device placed under their pillow, while ECG was recorded for 20 minutes. Time-domain indices (mean normal-to-normal (NN) interval) and frequency-domain indices (low frequency (LF) and high frequency (HF)) were calculated, and linear associations were examined by correlation analysis. Bland-Altman analysis was employed to evaluate the agreement between the indices. Results Significant positive associations were observed between BCG and ECG indices in mean NN interval (r=0.994, p<0.001) and LF (r=0.685, p<0.001) and HF (r=0.687, p<0.001). Bland-Altman analysis demonstrated good agreement in mean NN (mean of pairwise difference (MPD): 1.07; limits of agreement (LA): -12.57-14.70; ratio: 0.01), but poor agreement in LF (MPD: -4.32; LA: -30.42-21.78; ratio: 0.63) and HF (MPD: 4.29; LA: -21.70-30.28; ratio: 0.45) based on the ratios (> 0.2). Conclusion The high correlation and good agreement between mean NN intervals suggest that the BCG device can serve as an alternative to HRV for estimating NN interval.

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