The DOI matches its Crossref record; 112 of the 114 references it cites were found in a registry or an index.
How accurate is pulse rate variability as an estimate of heart rate variability?
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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“A comparative review of photoplethysmography against ECG stated that photoplethysmography can be used during rest but not during stress (Schafer and Vagedes, 2013).”
From Heart Rate Variability and Cardiac Vagal Tone in Psychophysiological Research – Recommendations for Experiment Planning, Data Analysis, and Data Reporting (2017) · cites this paper as Schafer and Vagedes, 2013
In the citing paper
“However, it cannot yet be considered to be a surrogate during exercise or stress [17], [129].”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [17]
In the citing paper
“Nonetheless, reviews have concluded that PRV is a good surrogate of HRV for certain applications at rest.”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [17]
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“Sankari,(2) certain studies have reported uncertainty about the accuracy of PRV compared to heart rate variability (HRV) in severe OSA patients and particularly for the frequency-domain indices.(3,4) However, more recent studies have shown that PRV is an accurate estimation of HRV in subjects at rest or in non-station…”
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“Generally, sympathovagal activity is analyzed by a heart rate variability examination, but it was also shown that PWVV could be used as a marker of autonomic nerve system activity [33].”
BackgroundIlie, A. C., Turcu, A.-M., Alexa‐Stratulat, T., Ștefăniu, R., Țăranu, S. M., Rotariu, C., Costin, H. N., & Alexa, I. D. (2022) · E-Health and Bioengineering Conference (EHB) · doi:10.1109/ehb55594.2022.9991453
“Another commonly used instrument to determine HRV is ECG Holter.”
MethodInfluentialInfluence of temperature on heart rate variability parameters
Murtazin, A. A., Maksjutov, N. F., Usenko, A. B., Izotov, A., Malsagova, K. A., Butkova, T. V., Stepanov, A. A., Petrov, A. A., & Balakin, E. I. (2023) · Russian Journal for Personalized Medicine · doi:10.18705/2782-3806-2022-2-6-42-53
Qi, Y., Zhang, A., Ma, Y., Chang, T., & Xu, J. (2023) · Journal of Medical Engineering & Technology · doi:10.1080/03091902.2023.2175061
“The paired T-test cannot thoroughly examine random errors, and the PCC is not sensitive to the relative error [23].”
BackgroundMethodInfluentialSahroni, A., Miladiyah, I., Widiasmara, N., & Setiawan, H. (2023) · Advances in Science Technology and Engineering Systems Journal · doi:10.25046/aj080309
Applications of Natural Time Analysis to Disaster Prediction in Other Disciplines indexNatural Time
Varotsos, P. A., Sarlis, N. V., & Skordas, E. S. (2023) · Springer eBooks · doi:10.1007/978-3-031-26006-3_13
Effect of Reperfusion on Time Domain Parameters of Heart Rate Variability
Mubarak, S., Riaz, B., Ashfaq, M., Hamid, S., Rasul, A., & Shafiq, M. (2023) · Journal of Rawalpindi Medical College · doi:10.37939/jrmc.v27i1.2246
Venezia, A., Jones, H., Hohenschurz‐Schmidt, D., Mancini, M., Howard, M. A., & Makovac, E. (2023) · medRxiv · doi:10.1101/2023.12.18.23299896
Kovaleva, A. V., & Николаевна, Л. Е. (2023) · Nauchno-prakticheskii zhurnal «Patogenez» · doi:10.25557/2310-0435.2023.03.54-57
Micro Monitor for Four Physiological Parameters from Fingertip
Zou, X., Li, R., Wu, Z., Zou, Y., & Chen, Q. (2023) · International Conference on Electronic Information Engineering and Computer Communication (EIECC) · doi:10.1109/eiecc60864.2023.10456719
Wang, S., Xing, H., & Liu, Y. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4791006
Guidotti, S., Torelli, P., Ambiveri, G., Fiduccia, A., Castaldo, M., & Pruneti, C. A. (2024) · Neurological Sciences · doi:10.1007/s10072-024-07739-7
Improved Hypertension Detection Models Utilizing Pulse Rate Variability and Asymmetry
Vraka, A., Fácila, L., Hornero, F., Gracia-Baena, J. M., Alcaraz, R., & Rieta, J. J. (2024) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-031-62520-6_19
Kriklenko, E. А., & Kovaleva, A. V. (2024) · Human Physiology · doi:10.31857/s0131164624040082
Hardon, H. J., Kerkhof, Y. N. V., Bartelds, B., Kammeraad, J. A. E., & van Deutekom, A. W. (2025) · doi:10.2196/preprints.70835
Kriklenko, E. А., & Kovaleva, A. V. (2024) · Human Physiology · doi:10.1134/s0362119724700841
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“When using PPG-derived pulse signals as a surrogate for HRV, it is important to consider the fundamental physiologi - cal differences between cardiac electrical activity and the peripheral pulse waveform [17, 18 ].”
Metadata
- 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)
- 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
- 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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