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Heart monitor line1/23/2024 ![]() ![]() ( b) Implantable cardiac rhythm monitor (Medtronic Reveal Linq). These findings are easily detected and rejected by trained human interpreters but remain challenging for automated rhythm analysis. An inappropriately marked artifact is seen (non-physiological signal, no repolarization). The algorithm detects the QRS intervals and transforms them into markers. ( a) consumer grade heart rate monitor (AliveCor Kardia). Due to wide range of cardiac pathology and various environmental factors, the potential for misinterpretation of artifacts remains high and ECGs are overread by trained practitioners in clinical practice ( Figure 1).Įlectrocardiographic recordings of heart activity. Proper detection of QRS complexes is of paramount importance to avoid registering signals not related to ventricular activity-this affects both HR and HRV calculations. For more complex analysis, such as arrhythmia morphology or ischemia, multi-channel ECG recordings are utilized. In practice, single channel recording is adequate to assess HR/HRV. Most clinical and commercial ECG-based heart rate monitors use algorithms to identify the QRS complex on the electrocardiogram, then transform it to a series of intervals (RR intervals), which are used to measure HR and changes of HR over time (HRV). The QRS complex represents the onset of ventricular contraction (systole), has the largest amplitude and easiest to detect. For each cycle of electrical cardiac activity, multiple signals can be seen on the body surface electrocardiogram-in normal sinus rhythm, these are usually a P wave (atrial depolarization), QRS complex (ventricular depolarization) and T wave (ventricular depolarization). ![]() The ease of measurement of the electrical activity and its strong correlation with mechanical and metabolic activity of the heart made electrocardiography (ECG) one of the most frequently performed non-invasive diagnostic tests.Ĭardiac activity generates a continuous electrical signal that must be recorded via electrodes, then filtered and digitalized for analysis. The heart is a complex multichambered pump with continuous mechanical and electrical activity. ![]() Electrical Cardiac Signal Generation, Recording After a historical perspective, data supporting the use of consumer grade devices will be reviewed, with current issues and future opportunities.Ģ. In this review, we will discuss the concepts behind cardiac signal generation, factors affecting HRV, methods of recording, processing and analysis. By reviewing the evidence behind specific aspects of ambulatory HR/HRV monitoring using wearable devices, we can get a better understanding on the appropriate use of this novel technology in this field. Recent reviews provide an overview on currently available devices and their proposed utility. As the utilization of these devices continues to increase, it is important to understand the physiological and technical aspects, together with the evidence supporting the uses of wearable technology for specific indications. Advances in analytic methods (linear, non-linear and most recently, machine learning) have the promise to extract more information from the gathered data. The ease of ambulatory heart rate measurement using consumer grade technology increased the interest of HR/HRV monitoring even in non-clinical applications. HRV has been extensively studied in clinical studies in various applications. Cardiovascular medicine-especially cardiac electrophysiology-has been an important driver in the evolution and utilization of wearable devices. Advances in technology made ambulatory monitoring of HR and HRV feasible-initially, in the medical field and more recently, using consumer grade devices in the general population. ![]() Heart rate (HR) and heart rate variability (HRV) are important physiologic markers of homeostasis and may provide an early warning for certain abnormal conditions. ![]()
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