CoChat
Sign Up
Cited by 18Non-Invasive Vital Sign MonitoringECG Monitoring and AnalysisHeart Rate Variability and Autonomic Control

Continuous heart rhythm monitoring using mobile photoplethysmography in ambulatory patients

Hochstadt, Aviram, Havakuk, Ofer, Chorin, Ehud, Schwartz, Arie Lorin, Merdler, Ilan, Laufer, Michal, Lubman, Natan, Ghantous, Eihab +2 more·2020·Journal of Electrocardiology
DOI 10.1016/j.jelectrocard.2020.04.017
Open this paper in CoChat — free account

Abstract

Background Wearable devices using photo-plethysmography (PPG) can accurately detect heart beats and may be useful for heart rate measurement and diagnosis of arrhythmias such as atrial fibrillation (AF). A previous study of a new portable PPG sensor (CardiacSense) showed high accuracy in heart rate measurement and AF detection in resting patients. We report a trial done to test the same device in active ambulatory patients with diverse characteristics.Methods A cohort of 24 ambulatory volunteers, underwent simultaneous PPG recording and continuous electrocardiogram (ECG) recording under different environmental conditions and situations. Per study protocol, the subjects were diverse in age, BMI, hair density and skin tone. Four subjects had AF. Heart rate measurement using the PPG device was compared to measurements by ECG.Results Of 163,527 recorded ECG-detected beats in the trial, 86,929 (53.2%) were also recorded by the PPG device. Most undetected heart beats were due to motion induced noise. Correlation between ECG and PPG was high (R = 0.94, p < 0.0001), yet in subjects with AF correlation was lower (R = 0.80, p < 0.0001). A Bland-Altman analysis showed the mean difference between measurements was -0.7 ms (95% limit of agreement -93.8 to 92.2). A total of 86,217 (99.9%) of all RR measurements were reliably measured (RR difference within 100 ms). Reliability was sustained (>99.8%) in subjects of all groups including subjects with AF.Conclusions This study showed that, in the absence of movement-related noise, the CardiacSense PPG device can reliably detect HR in a variety of situations and subjects' characteristics.

Integrity signals

Registry

Crossref · 10.1016/j.jelectrocard.2020.04.017

Cites

18 of 18 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Four of the ten included studies reported statistically significant reductions in heart rate measurement accuracy in participants with darker skin tones compared to participants with lighter skin tones.

    “Overall, four of the ten studies reported a significant reduction in accuracy of heart rate measurement with wearable devices in darker-skinned individuals, compared to participants with lighter skin tones.”

    From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [3]

  • Hemoglobin in dermal blood vessels drives the bulk of light absorption, and changes in blood pressure and flow rate affect light absorption, which is detected by PPG optical sensors.

    “Hemoglobin in dermal blood vessels drives the bulk of light absorption, and thus changes in blood pressure and flow rate affect light absorption, which is then detected by PPG optical sensors [2, 3].”

    From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [3]

  • Hochstadt et al. noted a linear regression coefficient of 0.98 (p < 0.001) when comparing PPG to ECG data in patients with darker skin (Fitzpatrick 5 or 6).

    “Hochstadt et al. noted a linear regression coefficient of 0.98 (p < 0.001) when comparing PPG to ECG data in patients with darker skin (Fitzpatrick 5 or 6), suggesting that darker skin tone reduced accuracy, albeit with a relatively small impact [3].”

    From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [3]

  • Darker skin tone reduced accuracy in the Hochstadt et al. comparison, albeit with a relatively small impact.

    “Hochstadt et al. noted a linear regression coefficient of 0.98 (p < 0.001) when comparing PPG to ECG data in patients with darker skin (Fitzpatrick 5 or 6), suggesting that darker skin tone reduced accuracy, albeit with a relatively small impact [3].”

    From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [3]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Hochstadt, A., Havakuk, O., Chorin, E., Schwartz, A. L., Merdler, I., Laufer, M., Lubman, N., Ghantous, E., Viskin, S., & Rosso, R.
Affiliations
Tel Aviv University (IL)
Corresponding author
Hochstadt, Aviram
ORCID
Venue
Journal of Electrocardiology
Publisher
Elsevier BV
Published
2020-05
Volume
60
Pages
138-141
ISSN
0022-0736 (ISSN-L)
DOI
10.1016/j.jelectrocard.2020.04.017
OpenAlex
W3020495863
Cited by
18
References
18
Citations by year
2026: 1 · 2025: 7 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 4
FWCI
0.63
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Electrocardiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Food and Drug Administration
  • U.S. Food and Drug Administration
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
photoplethysmography, heart rate monitoring, atrial fibrillation detection, wearable sensors, outpatients, motion artifacts, arrhythmia detection
MeSH terms
Wearable Electronic Devices, Atrial Fibrillation, Electrocardiography, Heart Rate, Humans, Reproducibility of Results, Photoplethysmography, Monitoring, Ambulatory

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review