Cited by 661Heart Rate Variability and Autonomic ControlNon-Invasive Vital Sign MonitoringCardiovascular Health and Disease Prevention

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How accurate is pulse rate variability as an estimate of heart rate variability?

Schäfer, Axel, Vagedes, Jan·2013·International Journal of Cardiology

DOI 10.1016/j.ijcard.2012.03.119

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Abstract

Background The usefulness of heart rate variability (HRV) as a clinical research and diagnostic tool has been verified in numerous studies. The gold standard technique comprises analyzing time series of RR intervals from an electrocardiographic signal. However, some authors have used pulse cycle intervals instead of RR intervals, as they can be determined from a pulse wave (e.g. a photoplethysmographic) signal. This option is often called pulse rate variability (PRV), and utilizing it could expand the serviceability of pulse oximeters or simplify ambulatory monitoring of HRV.Methods We review studies investigating the accuracy of PRV as an estimate of HRV, regardless of the underlying technology (photoplethysmography, continuous blood pressure monitoring or Finapresi, impedance plethysmography).Results/conclusions Results speak in favor of sufficient accuracy when subjects are at rest, although many studies suggest that short-term variability is somewhat overestimated by PRV, which reflects coupling effects between respiration and the cardiovascular system. Physical activity and some mental stressors seem to impair the agreement of PRV and HRV, often to an inacceptable extent. Findings regarding the position of the sensor or the detection algorithm are not conclusive. Generally, quantitative conclusions are impeded by the fact that results of different studies are mostly incommensurable due to diverse experimental settings and/or methods of analysis.

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STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965
Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use
Electrophysiology, T. F. O. T. E. S. O. C. T. N. A. (1996) · Circulation · doi:10.1161/01.cir.93.5.1043 · Cited by 17,159
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289
A concordance correlation coefficient to evaluate reproducibility.
Lin, L. I.-K. (1989) · Biometrics · doi:10.2307/2532051 · Cited by 8,785
Power Spectrum Analysis of Heart Rate Fluctuation: A Quantitative Probe of Beat-to-Beat Cardiovascular Control
Akselrod, S., Gordon, D., Ubel, F. A., Shannon, D. C., Berger, A. C., & Cohen, R. J. (1981) · Science · doi:10.1126/science.6166045 · Cited by 5,079
Decreased heart rate variability and its association with increased mortality after acute myocardial infarction
Kleiger, R. E., Miller, J. P., Bigger, J. T., & Moss, A. J. (1987) · The American Journal of Cardiology · doi:10.1016/0002-9149(87)90795-8 · Cited by 3,995
Photoplethysmography and its application in clinical physiological measurement
Allen, J. (2007) · Physiological Measurement · doi:10.1088/0967-3334/28/3/r01 · Cited by 3,967
Assessment of autonomic function in humans by heart rate spectral analysis
Pomeranz, B., Macaulay, R. J., Caudill, M. A., Kutz, I., Adam, D., Gordon, D., Kilborn, K. M., Barger, A. C., Shannon, D. C., Cohen, R. J., et al. (1985) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1985.248.1.h151 · Cited by 2,876
Comparing methods of measurement: why plotting difference against standard method is misleading
Bland, J. M., & Altman, D. G. (1995) · The Lancet · doi:10.1016/s0140-6736(95)91748-9 · Cited by 2,343
Impact of Reduced Heart Rate Variability on Risk for Cardiac Events: The Framingham Heart Study
Tsuji, H., Larson, M. G., Venditti, F. J., Manders, E. S., Evans, J. C., Feldman, C. L., & Levy, D. (1996) · Circulation · doi:10.1161/01.cir.94.11.2850 · Cited by 1,762

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Herzman, 1937, Observations on the finger volume pulse recorded photoelectrically, Am J Physiol, 119, 334
Janssen, 1994, Methods in heart rate variability analysis: may the ventricular or the pulse rhythm be used as a substitute for the atrial rhythm?, High Blood Pressure, 3, 23
Khandoker, 2011, Comparison of pulse rate variability with heart rate variability during obstructive sleep apnea, Med Eng Phys, 33, 204, 10.1016/j.medengphy.2010.09.020 · DOI

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Age-related alterations in the sign series entropy of short-term pulse rate variability
Chou, Y., Zhang, A., & Yang, B. (2016) · Neurocomputing · doi:10.1016/j.neucom.2016.09.094 · Cited by 6
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“…the literature, HRV analysis lasting around 5 min reflects interactions between the sympathetic and parasympathetic branches, respiratory sinus arrhythmia modulation, the baroreceptor reflex regulation of blood pressure, and rhythmic adjustments in blood vessel diameter (Schäfer and Vagedes 2013).”
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“95) [8].”
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Background
Increasing Stability of Real-Time Pulse Wave Velocity Estimation by Combining Established and New Approaches
Bachler, M., Mayer, C. C., Hametner, B., & Wassertheurer, S. (2013) · EUROSIM Congress on Modelling and Simulation (EUROSIM) · doi:10.1109/eurosim.2013.18 · Cited by 5
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“HRV was derived from continuous blood pressure measurements, as pulse rate variability has demonstrated comparable reliability to traditional HRV assessments under resting conditions 28 .”
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“The IBI out-lier detection algorithm proposed in [7, 17] for ECG signals can be used for PPG signals because RR-intervals from ECG are found to align closely with PP-intervals from PPG signals [18, 19].”
Method
Tiny ML-based Non-Invasive Approach of Cardiac Monitoring
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“One of the commonly used surrogate metrics is the pulse rate variability, which provides valuable insights into the autonomic nervous system and can be indicative of stress levels, physical exertion, and overall cardiovascular fitness [4].”
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“As for the HRV measurement method, the heartbeat interval change and continuous pulse cycle change are generally measured [20].”
Method
Heart Rate Extraction From Neonatal Near-Infrared Spectroscopy Signals
Hakimi, N., Horschig, J. M., Alderliesten, T., Bronkhorst, M., Floor, M., van Bel, F., Colier, W. N. J. M., & Dudink, J. (2023) · IEEE Transactions on Instrumentation and Measurement · doi:10.1109/tim.2023.3295015 · Cited by 4
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Abiri, A., Chou, E., Shen, W., Fisher, M., & Khine, M. (2023) · Scientific Reports · doi:10.1038/s41598-023-45479-4 · Cited by 4
“…those of Wang et al. Furthermore, it is important to note that our analyses used PRV, which has been reported to behave differently than HRV in some clinical contexts and slightly overestimate short-term variability due to coupling effects between respiration and the cardiovascular system 39,66 .”
Method
A multimodal stacked ensemble model for cardiac output prediction utilizing cardiorespiratory interactions during general anesthesia
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Sakuragi, M., Shinagawa, K., Terasawa, Y., & Umeda, S. (2024) · Consciousness and Cognition · doi:10.1016/j.concog.2024.103770 · Cited by 6
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Peiris, T., Shahidi, A. M., Koutsogeorgis, D. C., Hurley, W., de Oliveira, C. R. M., Dias, T., & Riley, T. H. (2024) · International Conference on the Challenges, Opportunities, Innovations and Applications in Electronic Textiles (E-Textiles) · doi:10.23919/e-textiles63767.2024.10914070 · Cited by 4
Gamification on Steppy application in the development of the electronic health record as health service users of SHESOP
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Nano, M.-M., Papini, G. B., Fonseca, P. P., Vullings, R., Overeem, S., Bergmans, J. J., & Aarts, R. M. (2017) · TU/e Research Portal · Cited by 4
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Killian, J. M., Radin, R. M., Gardner, C. L., Kasuske, L., Bashirelahi, K., Nathan, D. E., Keyser, D. O., Cellucci, C. J., Darmon, D. M., & Rapp, P. E. (2021) · Behavioral Sciences · doi:10.3390/bs11050068 · Cited by 4
“The measurement reliability results of this investigation are concordant with published literature comparing methods of assessing HRV [4,22,23], and suggest that the assessed devices are equally capable of collecting valid measures in normal healthy subjects.”
Result
Heart Rate Variability as a Potential Non-invasive Marker of Blood Glucose Level
Jarman, L. R., Elliott, J. L., Lees, T., Clifton-Bligh, R. J., Simpson, A. M., Nassif, N. T., & Lal, S. (2021) · Human Physiology · doi:10.1134/s0362119721020031 · Cited by 4
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Detection of Drowsiness Using the Pulse Rate Variability of Finger
Heydari, S., Ayatollahi, A., Najafi, A., & Poorjafari, M. (2022) · SN Computer Science · doi:10.1007/s42979-022-01247-1 · Cited by 4
“Some studies have been done to replace the HRV with the PRV since the pulse rate is more easily obtained compared to the heart rate [7, 10, 15].”
Background
Long- and short-term fluctuations compared for several organ systems across sleep stages
Zschocke, J., Bartsch, R. P., Glos, M., Penzel, T., Mikolajczyk, R., & Kantelhardt, J. W. (2022) · Frontiers in Network Physiology · doi:10.3389/fnetp.2022.937130 · Cited by 4
“Furthermore, we found a close similarity between HRV parameters (from RRI, top row in Figure 2) and pulse rate variability parameters (from PPI, second row in Figure 2), confirming our Hypothesis 3 from the Introduction.”
BackgroundResultInfluential
Channel Intensity and Edge-Based Estimation of Heart Rate via Smartphone Recordings
Krishnamoorthy, A., Bairy, G. M., Siddeshappa, N., Mayrose, H., Sampathila, N., & Chadaga, K. (2023) · Computers · doi:10.3390/computers12020043 · Cited by 4
Recent Innovations and Improvements in Remote Heart Rate and Heart Disease Measuring Methods Using RGB Camera
Balaraman, K., & Claret, S. P. A. (2023) · International Conference on Circuit, Power and Computing Technologies · doi:10.1109/iccpct58313.2023.10245666 · Cited by 4
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Method
An improved algorithm for the detection of photoplethysmographic percussion peaks
Luo, F., Li, J., Yun, F., Chen, T., & Chen, X. C. (2014) · International Congress on Image and Signal Processing (CISP) · doi:10.1109/cisp.2014.7003906 · Cited by 4
“…of Life Science and Technology, Xi'an Jiaotong University, Xi’an, Shaanxi, P.R.China 2 Solid State Lighting Engineering Research Center, Xi'an Jiaotong University, Xi’an, Shaanxi, P.R.China 3 The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi’an,…”
BackgroundInfluential
The factors influence compatibility of pulse-pulse intervals with R-R intervals
Liu, A., Wu, H., Liu, C.-C., Hsu, C.-H., & Chen, D.-Y. (2013) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2013.6609939 · Cited by 4
Real-time heart activity monitoring with optical illusion using a smartphone
Thap, T., Chung, H., Jeong, C., Ryu, J., Nam, Y., Yoon, K., & Lee, J. (2017) · Multimedia Tools and Applications · doi:10.1007/s11042-017-4530-3 · Cited by 4
“Many applications on smartphones for out-of-clinic patient use have been released with peripheral medical devices that plug into or arewirelessly connected to a smartphone [18, 20, 25, 30, 34, 36].”
Background
Mobile Device for Monitoring of Cardiovascular System State Based on Assessment of Synchronization of its Low-Frequency Rhythms
Prokhorov, M. D., Kulminskiy, D. D., Borovkova, E. I., Karavaev, A. S., Пономаренко, В. И., Kiselev, A. R., & Bezruchko, B. P. (2018) · The Open Hypertension Journal · doi:10.2174/1876526201810010046 · Cited by 4
Resonance Frequency Assessment: The Challenge of Standardizing Heart Rate Variability Biofeedback Research
Shaffer, F. (2020) · Biofeedback · doi:10.5298/1081-5937-48.01.06 · Cited by 4
Immediate Autonomic Nervous System Activity in Skin Microcirculation During Osteopathic Cranial Vault Hold InterventionPreprint
Pelz, H., Keller, M., Müller, G., Mathiak, K., Borik, Š., Mayer, J., & Perlitz, V. (2022) · Research Square · doi:10.21203/rs.3.rs-2409912/v1 · Cited by 4
Effects of cortisol administration on heart rate variability and functional connectivity across women with different depression histories
Philippi, C. L., Weible, E., Ehlers, A., Walsh, E. C., Hoks, R. M., Birn, R. M., & Abercrombie, H. C. (2024) · Behavioural Brain Research · doi:10.1016/j.bbr.2024.114923 · Cited by 4
A lightGBM-based method for the signal quality assessment of wrist photoplethysmography
Wang, J., Hui, H., Yang, H., Pengfei, X., & Ji, Z. (2025) · Physical and Engineering Sciences in Medicine · doi:10.1007/s13246-025-01616-z · Cited by 3
“Beyond fundamental pulse rate detection, pulse rate variability (PRV) serves as a valid surrogate for heart rate variability, reflecting autonomic nervous system activity [ 14, 15 ].”
The cardiac rhythm invariance Principle: A unified framework for multimodal cardiac signal analysis
Abdessalem, K. B. (2026) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2025.109148 · Cited by 4
A systematic and bibliometric review on physiological monitoring systems and wearable sensing devices for mental status monitoring in construction: Trends, limitations, and future directions
Xu, D., & Albeaino, G. (2025) · Journal of Information Technology in Construction · doi:10.36680/j.itcon.2025.075 · Cited by 3
Biomedical Signal Processing: The Cornerstone of Artificial Intelligence in Healthcare Wearables
Valenza, G. (2022) · Biomedical Materials & Devices · doi:10.1007/s44174-022-00051-y · Cited by 4
The Effect of Device-Controlled Breathing on the Pulse Arrival Time and the Heart Rate Asymmetry Parameters in Healthy Volunteers
Ajtay, B. E., Béres, S., & Hejjel, L. (2023) · Applied Sciences · doi:10.3390/app13095642 · Cited by 3
Pulse rate variability and health-related quality of life assessment with the Short Form-8 Japanese version in the general Japanese population
Saito, I., Maruyama, K., Yamauchi, K., Funakoshi, Y., Kato, T., Kawamura, R., Takata, Y., & Osawa, H. (2024) · Scientific Reports · doi:10.1038/s41598-024-54748-9 · Cited by 3
Comprehensive Mitigation of Peripheral and Central Stress Responses by Nx4: Insights From EEG and Heart Rate Variability in Post‐Stress Resting State
Krylova, M., Alizadeh, S., Jamalabadi, H., Izyurov, I., Chand, T., van der Meer, J. N., Vester, J., Naschold, B., Schultz, M., Engert, V., et al. (2025) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.70020 · Cited by 3
“PPG serves as a well‐ established alternative to ECG for HRV evaluations, particularly under resting state conditions (Lu et al. 2009; Podaru et al. 2018; Schäfer and Vagedes 2013).”
Accuracy of pulse interval timing in ambulatory blood pressure measurement
Kane, S., Blake, J. R., McArdle, F., Langley, P., & Sims, A. (2016) · Scientific Reports · doi:10.1038/srep37472 · Cited by 3
Evaluation of a real-time low-power cardiorespiratory sensor for the IoT
Gatouillat, A., Massot, B., Badr, Y., Sejdić, E., & Géhin, C. (2018) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2018.8513550 · Cited by 3
“This paper only focuses on the development and evaluation of ECG-based cardiac activity sensor systems, as the reliability of other techniques such as photoplethysmography are sometimes challenged by the medical community [4].”
Method
Impact of Equine-Assisted Interventions on Heart Rate Variability in Two Participants with 22q11.2 Deletion Syndrome: A Pilot Study
Amado-Fuentes, M., Delgado, M. G., Gómez, A. G., & My works are correct, B. M. I. A. A. I. S. R. L. M. T. I. D. A.-M. (2021) · Children · doi:10.3390/children8111073 · Cited by 4
“Concerning each participant: • Participant 1, who performed the EAIs without riding, showed a great magnitude of effect, with an increase in HRV before the session and lower stress levels after the EAI intervention.”
MethodInfluential
Methodological Issues
Ernst, G. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4309-3_4 · Cited by 3
A wearable heart rate monitoring system based on over-ear headphones
Voropai, A., & Sarana, V. (2022) · Journal of Medical Engineering & Technology · doi:10.1080/03091902.2022.2080884 · Cited by 3
“These alternative methods are indirect ways of registering heart activity, they can’t provide ECG level accuracy [5].”
Method
Potential of electronic devices for detection of health problems in older adults at home: A systematic review and meta-analysis
Cao, Y., Zhao, X., Yang, Y., Zhu, S., Zheng, L.-D., Ying, T., Sha, Z., Zhu, R., & Wu, T. (2023) · Geriatric Nursing · doi:10.1016/j.gerinurse.2023.02.007 · Cited by 3
Synchronous measurements of prefrontal activity and pulse rate variability during online video game playing with functional near-infrared spectroscopy
Zhang, X., Long, K., Wang, N., Zhang, J., & Hao, L. (2023) · Journal of Innovative Optical Health Sciences · doi:10.1142/s1793545823400059 · Cited by 3
Affective gaming using adaptive speed controlled by biofeedback
Frachi, Y., Chanel, G., & Barthet, M. (2023) · INTERNATIONAL CONFERENCE ON MULTIMODAL INTERACTION · doi:10.1145/3610661.3616124 · Cited by 3
“Results were confrmed by Schafer (2013) and his review of studies [22].”
Background
Evidence-Based Clinical Utility of Heart Rate Variability Across Populations, Including Long COVID
Steere, K. B. (2024) · Cardiopulmonary Physical Therapy Journal · doi:10.1097/cpt.0000000000000270 · Cited by 3
ECG changes in patients with opioid use disorder; P-QT wave dispersion: a retrospective study
Demir, B., Özsoy, F., Büyük, A., & Altındağ, A. (2020) · Journal of Addictive Diseases · doi:10.1080/10550887.2020.1848257 · Cited by 3
“In another study, it was found that the heart rate of patients with generalized anxiety disorder was higher than the healthy controls, but the result obtained did not show a statistically significant difference.(26) In a study conducted on patients diagnosed with heroin use disorder, it was shown that the heart rates…”
Result
Assessment of Heart Rate Variability derived from Blood Pressure Pulse Recordings in Intensive Care Unit Patients
Mollura, M., Polo, E. M., Lehman, L.-W. H., & Barbieri, R. (2020) · Computing in cardiology · doi:10.22489/cinc.2020.423 · Cited by 3
“Previous studies [8, 9] have analyzed the possibility of using Pulse Rate Variability (PRV) to replace specific HRV features under different conditions.”
BackgroundResult
Towards efficient heart rate variability estimation in artifact-induced Photoplethysmography signals
Alqaraawi, A., Alwosheel, A., & Alasaad, A. (2016) · Conference proceedings - Canadian Conference on Electrical and Computer Engineering · doi:10.1109/ccece.2016.7726853 · Cited by 3
“Schfer et al. conducted a survey of methods used for detecting peaks [11].”
Method
Nail tip sensor: Toward reliable daylong monitoring of heart rate
Ishii, K., & Hiraoka, N. (2020) · IEEJ Transactions on Electrical and Electronic Engineering · doi:10.1002/tee.23132 · Cited by 3
Heart Rate Variability and Multi-Site Pulse Rate Variability for the Assessment of Autonomic Responses to Whole-Body Cold Exposure
Mejía‐Mejía, E., Budidha, K., Abay, T. Y., May, J. M., & Kyriacou, P. A. (2020) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc44109.2020.9175856 · Cited by 3
“PRV has been found to be influenced by technical factors, such as the fiducial points used for measuring the cardiac cycles [8], and the sampling rate of the PPG signal [9]; as well as by physiological aspects, such as the variability of the pulse transit time [10], the nature of the PPG and ECG signals [7], and chang…”
BackgroundInfluential
Extremely Lightweight Skin Segmentation Networks to Improve Remote Photoplethysmography Measurement
Lee, K., You, H., Oh, J., & Lee, E. C. (2023) · Lecture notes in computer science · doi:10.1007/978-3-031-27199-1_45 · Cited by 3
Assessment of agreement between pulse rate variability and heart rate variability depending fiducial point in multi-site photoplethysmography
Zawadzka, S., & Sondej, T. (2025) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2025.108055 · Cited by 2
A lightweight uncertainty modeling approach for wearable sensor signals based on sample overlap estimation
Sun, Y., Li, S. S., Sun, W., Jin, T., Guo, M., Fu, M., Liu, D., & Huang, X. M. (2025) · Measurement · doi:10.1016/j.measurement.2025.120051 · Cited by 2
Cardiac vagal tone is associated with physical activity but not with depressive symptoms, work stress, and social support: A large‐scale 10‐year follow‐up study
Li, Z., Chen, S., Rietzschel, E. R., Kozusznik, M. W., Hoecke, S. V., Vanderhasselt, M., & Pulopulos, M. M. (2025) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.70107 · Cited by 2
Autonomic Nervous System Adaptation to Supernumerary Robotic Finger Use: Coherence Analysis of RR Intervals Before and After Training
Younis, S. M. A., Awad, M. I., Katmah, R., Alskafi, F. A., Jelinek, H. F., & Khalaf, K. A. (2026) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2026.3658402 · Cited by 2
“Following peak detection, the signals were down-sampled to 4 Hz to comply with conventional HRV analysis guidelines and reduce the computing load without eliminating key temporal information [42], [43].”
Advancing remote photoplethysmography (rPPG) to facilitate cardiac monitoring in naturalistic settings using webcam technology
Woelk, S. P., Garfinkel, S. N., Mayiwar, L., & Knöferle, K. (2026) · Behavior Research Methods · doi:10.3758/s13428-026-02953-x · Cited by 2
“An alternative method for collecting cardiac data is photoplethysmography (PPG) (Gil et al., 2010; Schäfer & Vagedes, 2013).”
Slow breathing impacts inter-organ dynamics modulating brain function and risk behavior
Huang, W., Schmidt, M., Rebollo, I., Molter, F., Pu, M., Keweloh, B., Lam, L. Y., Mohr, P. N. C., Bellucci, G., Röttger, S., et al. (2026) · Neuron · doi:10.1016/j.neuron.2026.04.044 · Cited by 2
Reducing Motion Artifacts of Pulse Intervals from Photoplethysmogram of a Commercial Wristband for Heart Rate Variability Analysis
Wang, H., Jimison, H., & Misha Pavel, C. (2021) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc46164.2021.9630551 · Cited by 2
“In the case of PPG, beat by beat heart period data can be can be obtained by detecting systolic peaks of the PPG signal [9].”
The impact of unfavorable and toxic environmental conditions on autonomic tone modulations while wearing N95 face masks
Erkudov, V. O., Pugovkin, A., Rozumbetov, K. U., Матчанов, А. Т., Arachchi, S., & Rathnayake, U. (2024) · Case Studies in Chemical and Environmental Engineering · doi:10.1016/j.cscee.2024.100619 · Cited by 2
Examining the Light Heart Mobile Device App for Assessing Human Pulse Interval and Heart Rate Variability: Validation Study
Klassen, S. A., Jabbar, J., Osborne, J., Iannarelli, N. J., Kirby, E. S., O’Leary, D. D., & Locke, S. (2024) · JMIR Formative Research · doi:10.2196/56921 · Cited by 2
“Accordingly, to extend HRV measures beyond laboratory and clinical environments, methods have been developed that rely on photoplethysmography (PPG) to measure pulse interval from the pulsatile changes in microcirculatory blood volume in an accessible anatomical location such as a finger [11].”
Method
Innovative Pulse Monitoring: Exploring Auscultation-Based Diagnostic Technique
Kumar, S., Tayade, A., Kumar, P., & Ravi, B. (2024) · International Conference on Biomedical and Bioinformatics Engineering (ICBBE) · doi:10.1145/3707127.3707146 · Cited by 2
“In recent years, Pulse Rate Variability (PRV) has been used as a surrogate for HRV, and studies have shown a high correlation between PRV and HRV when measurements are taken at rest [12].”
Enhanced Joint Heart and Respiratory Rates Extraction from Functional Near-infrared Spectroscopy Signals Using Cumulative Curve Fitting Approximation
Adib, N., Setarehdan, S. K., Tondashti, S. A., & Yaghoubi, M. (2025) · Journal of Medical Signals & Sensors · doi:10.4103/jmss.jmss_48_24 · Cited by 2
“[17] Numerous studies have aimed to measure HR and HRV using fNIRS signals.”
Influential
Predicting Heart Rate Estimation Accuracy: Photoplethysmography Sensor Measurements on Eight Anatomical Sites *
Khalili, M., Lingawi, S., Hutton, J., Christenson, J. M., Shadgan, B., Grunau, B. E., & Kuo, C. (2025) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc58623.2025.11253258 · Cited by 3
Autonomic Modulation During a Cognitive Task Using a Wearable Device
Bonomini, M. P., Val-Calvo, M., Díaz‐Morcillo, A., Vicente, J. M. F., & Fernández-Jover, E. (2019) · Lecture notes in computer science · doi:10.1007/978-3-030-19591-5_8 · Cited by 3
Comparison of Heart Rate Variability and Pulse Rate Variability of Respiratory Control
Han, Y., Lin, W., Huang, S., Tsai, C.-L., & Lin, K. (2018) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-981-10-4505-9_44 · Cited by 2
Effects of Astaxanthin on Pulse Rate Variability of Mice Under Chronic Stress
Escutia-Reyes, D., Oros‐Pantoja, R., Lagos, J. J. R., Pliego‐Carrillo, A. C., Ramírez, C. I. L., Rodríguez-Muñoz, D., & García, E. T. (2019) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-030-30648-9_95 · Cited by 2
Proposal of Procedure for Heart Rate Variability Monitoring in Oncologic Patients Using a New Technology
Ilie, A. C., Costin, H. N., Pîslaru, A. I., Alexa‐Stratulat, T., Rotariu, C., Sandu, I. A., Costin, D., & Alexa, I. D. (2019) · E-Health and Bioengineering Conference (EHB) · doi:10.1109/ehb47216.2019.8970043 · Cited by 2

Authors: Schäfer, A., & Vagedes, J.
Affiliations: Academic Research in Complementary and Integrative Medicine (DE)
University Children's Hospital Tübingen (DE)
Corresponding author: Vagedes, Jan
ORCID: Vagedes, Jan
Venue: International Journal of Cardiology
Publisher: Elsevier BV
Published: 2013-06
Volume: 166
Issue: 1
Pages: 15-29
ISSN: 0167-5273 (ISSN-L)
DOI: 10.1016/j.ijcard.2012.03.119
OpenAlex: W188715143
Cited by: 661
References: 114
Citations by year: 2026: 59 · 2025: 51 · 2024: 56 · 2023: 52 · 2022: 57 · 2021: 72 · 2020: 67 · 2019: 49 · 2018: 59 · 2017: 40 · 2016: 40 · 2015: 29 · 2014: 19 · 2013: 9
FWCI: 11.94
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords: pulse rate variability, heart rate variability, photoplethysmography, pulse oximetry, RR interval, measurement accuracy, physical activity, psychological stress, sensor position, detection algorithm, ambulatory monitoring
MeSH terms: Electrocardiography, Heart Rate, Humans, Motor Activity, Pulse, Rest, Photoplethysmography

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How accurate is pulse rate variability as an estimate of heart rate variability?

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