Abstract
BackgroundThe 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.MethodsOne 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).ResultsData 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.ConclusionHeart 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.
Highlights
The need for unobtrusive Heart rate (HR) monitoring has led to the development of a new generation of strapless HR monitors
In the 1980s, the growing need for HR monitoring in the sport industry market led to the development of wireless, wearable HR monitoring devices consisting of dry electrodes mounted on a chest strap sensor and a wristwatch radio receiver [6, 7]
The need for less obtrusive HR monitoring led to the development of a new generation of strapless HR monitors, most of which are based on photoplethysmography (PPG) [15]
Summary
The need for unobtrusive HR (heart rate) monitoring has led to the development of a new generation of strapless HR monitors. In the 1980s, the growing need for HR monitoring in the sport industry market led to the development of wireless, wearable HR monitoring devices consisting of dry electrodes mounted on a chest strap sensor and a wristwatch radio receiver [6, 7] They have been extensively validated in a large range of activities showing high overall accuracy (i.e., concordance correlation coefficient = 0.99; limits of agreement, LoA ± 2 bpm; ICC = 0.99) [8,9,10,11].
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