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Related Experiment Video

Updated: Feb 7, 2026

Using Fiberless, Wearable fNIRS to Monitor Brain Activity in Real-world Cognitive Tasks
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Translational Methods for Wearable Heart Rate Variability Monitoring in Older Adults: Preoperative Risk

Nathaniel Brooke1,2, Kenneth C Roberts3, Sloan A Soyster Heinz1

  • 1Department of Anesthesiology, Duke University School of Medicine, LSRC Office B255, 308 Research Drive, Durham, NC, 27710, USA.

Journal of Cardiovascular Translational Research
|February 5, 2026
PubMed
Summary

Wrist-worn wearables can capture heart rate variability (HRV) data before surgery. However, high-risk patients have more missing data after surgery, limiting wearable use for predicting outcomes.

Keywords:
AgingAutonomic nervous systemBrain–heart-immune axisDeliriumGeriatric surgeryHeart rate variabilityPerioperative medicinePhotoplethysmographyRemote monitoringWearables

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Area of Science:

  • Geriatric Medicine
  • Cardiovascular Physiology
  • Medical Technology

Background:

  • Low preoperative heart rate variability (HRV) is linked to poor outcomes and delirium in older surgical patients.
  • Current HRV testing methods are impractical for remote, perioperative monitoring.

Purpose of the Study:

  • To assess the feasibility of using wrist-based wearables for remote HRV data collection.
  • To evaluate outpatient and inpatient HRV data quality and missingness patterns.
  • To explore the association between postoperative HRV and delirium incidence.

Main Methods:

  • RR-intervals were extracted from wearable device data.
  • Data missingness was analyzed for systematic differences.
  • Delirium incidence was recorded and compared with HRV metrics.

Main Results:

  • High-quality preoperative outpatient HRV data were obtained from 76.9% of participants.
  • High-quality postoperative inpatient HRV data were obtained from 80.2% of participants.
  • Missing postoperative data were more common in older, higher-risk patients (e.g., longer surgeries, ICU stays).
  • No significant difference in postoperative HRV was found between patients with and without delirium.

Conclusions:

  • Wrist-worn wearables are feasible for remote preoperative HRV monitoring in older surgical patients.
  • Challenges remain in collecting complete inpatient HRV data from higher-risk patients.
  • Wearable HRV monitoring shows potential but has limitations for perioperative outcome prediction.