Heart rate turbulence analysis based on photoplethysmography

Area of Science:

• Biomedical Engineering
• Cardiovascular Physiology
• Medical Diagnostics

Background:

• Electrocardiography (ECG) is standard for heart rate turbulence (HRT) analysis.
• Ventricular premature beats (VPBs) impact HRT.
• Alternative methods for HRT analysis are needed.

Purpose of the Study:

• To evaluate photoplethysmography (PPG) as a substitute for ECG in detecting heart rate turbulence.
• To assess PPG's efficacy in classifying ventricular premature beats (VPBs).

Main Methods:

• Utilized PPG signals for VPB classification via a linear classifier.
• Analyzed conventional turbulence onset and slope parameters, plus a novel turbulence shape parameter.
• Evaluated performance on a dataset of 4131 VPBs from 27 patients across diverse clinical contexts.

Main Results:

• Achieved 90.5% sensitivity and 99.9% specificity for VPB classification using PPG, with 99.3% overall accuracy.
• Identical turbulence analysis outcomes between ECG and PPG in 21 out of 22 patients with sufficient VPBs.
• Pulse transit time variability post-VPB was a key differentiator in analysis.

Conclusions:

• PPG demonstrates high reliability for VPB classification and heart rate turbulence analysis.
• PPG can serve as a surrogate for ECG in turbulence analysis.
• This finding has implications for non-invasive cardiovascular monitoring.