Validation of the Polar V800 heart rate monitor and comparison of artifact correction methods among adults with hypertension

Burak Cilhoroz,Bo Fernhall,David Giles,Linda Pescatello,Amanda Zaleski,Beth Taylor,Daniel Boullosa

doi:10.1371/journal.pone.0240220

Abstract

Heart rate variability (HRV) measurements via ambulatory monitors have become common. We examined the validity of recording R-R intervals using the Polar V800™ compared to 12-lead electrocardiograms (ECG) among middle-aged (44.7±10.1years); overweight to obese (29.8±4.3 kg.m-2) adults (n = 25) with hypertension (132.3±12.2/ 84.3±10.2 mmHg). After resting for 5-min in the supine position, R-R intervals were simultaneously recorded using the Polar V800™ and the 12-lead ECG. Artifacts present in uncorrected (UN) R-R intervals were corrected with the Kubios HRV Premium (ver. 3.2.) automatic (AC) and threshold-based (TBC) correction, and manual correction (MC) methods. Intra-class correlation coefficients (ICC), Bland-Altman limits of agreement (LoA), and effect sizes (ES) were calculated. We detected 71 errors with the Polar V800™ for an error rate of 0.85%. The bias (LoAs), ES, and ICC between UN and ECG R-R intervals were 0.69ms (-215.80 to +214.42ms), 0.004, and 0.79, respectively. Correction of artifacts improved the agreeability between the Polar V800™ and ECG HRV measures. The biases (LoAs) between the AC, TBC, and MC and ECG R-R intervals were 3.79ms (-130.32 to +137.90ms), 1.16ms (-92.67 to +94.98ms), and 0.37ms (-41.20 to +41.94ms), respectively. The ESs of AC, TBC, and MC were 0.024, 0.008, and 0.002, and ICCs were 0.91, 0.95, and 1.00, respectively. R-R intervals measured using the Polar V800™ compared to 12-lead ECG were comparable in adults with hypertension, especially after the artifacts corrected by MC. However, TBC correction also yielded acceptable results.

Highlights

Hypertension is the most common, costly, and preventable cardiovascular disease risk factor [1] in the US with nearly one in two American adults having hypertension [2]
We compared uncorrected and corrected R-R intervals and heart rate variability (HRV) measures derived from the Polar V800TM heart rate (HR) monitor to the gold standard 12-lead ECG, with the aim of determining their level of agreement among adults with hypertension
We sought to determine the accuracy of the manual correction (MC), AC and threshold-based correction (TBC) methods of Kubios HRV Premium in correcting artifacts among this sample

Summary

Introduction

Hypertension is the most common, costly, and preventable cardiovascular disease risk factor [1] in the US with nearly one in two American adults having hypertension [2]. Modifiable (e.g., obesity, physical inactivity, smoking, dyslipidemia) and non-modifiable (e.g., age, gender, family history) risk factors can increase the likelihood of developing hypertension [2]. One of the hypotheses regarding the initiation, progression, and maintenance of hypertension is alterations in the neural control of blood pressure (BP) [3]. The sinoatrial node integrates the inputs from the ANS to adjust heart rate (HR) in response to the constantly changing internal and external environment to maintain homeostasis [4]. This adjustment causes an oscillatory pattern in the HR resulting from beat-to-beat fluctuations in the time period between sequential heartbeats, termed heart rate variability (HRV).

Objectives

Methods

Conclusion