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Heart Rate Variability in Congenital Heart Disease and Controls Using Wearable Technology and a Health Application
Charlotte Schöneburg1, Isabel Uphoff2, Renate Oberhoffer-Fritz1,2
1Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technische Universität München, München, Germany.
Insights
Adults with congenital heart disease (CHD) have lower heart rate variability (HRV), particularly during nighttime recovery. Wearable devices and health APIs can aid in monitoring autonomic function and personalizing care for chronic conditions.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Digital Health
Background:
- Focus on long-term morbidity in adults with congenital heart disease (CHD) due to increased survival rates.
- Chronic conditions in CHD patients impose cardiac and psychological burdens impacting autonomic function.
- Heart rate variability (HRV) is a key indicator of autonomic nervous system activity.
Purpose of the Study:
- To compare HRV levels between adults with CHD and healthy controls.
- To investigate the impact of CHD on autonomic function, specifically HRV.
- To assess the utility of wearable technology for physiological monitoring in CHD patients.
Main Methods:
- A wearable-based physiological assessment was conducted over 7 days using Garmin vivosmart 5 devices.
- 124 adults with CHD and 43 controls participated in the study.
- Heart rate variability (HRV) was continuously recorded, and the root mean square of successive differences (rMSSD) was calculated for day and nighttime.
Main Results:
- Adults with CHD exhibited significantly lower overall HRV (rMSSD) compared to controls.
- The reduction in HRV for CHD patients was primarily driven by decreased nighttime HRV.
- Controls showed a greater increase in HRV from day to night, indicating better autonomic recovery.
- VO2 peak positively correlated with daytime and overall HRV in CHD patients.
Conclusions:
- Adults with CHD demonstrate diminished overall and nighttime HRV compared to controls.
- Nighttime HRV is crucial for assessing recovery, sleep quality, and overall health in CHD.
- Continuous monitoring through health APIs offers potential for reliable chronic disease assessment and personalized care.
Background:
With 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health conditions are associated with increased cardiac and psychological burdens, which could influence autonomic function. This study compares heart rate variability (HRV) levels between adults with CHD and controls.
Methods:
Between September 2023 and February 2024, 124 adults with CHD (33.7 ± 10.5 years, 47.6% women) and 43 controls (34.3 ± 12.0 years, 44.2% women) participated in a wearable-based physiological assessment. HRV was continuously recorded using Garmin vivosmart 5 for 7 days, with data synchronized via a health application programming interface. The root mean square of successive differences (rMSSD) was calculated for day and nighttime based on individual sleep and waking schedules.
Results:
Patients with CHD exhibited lower overall rMSSD than controls (CHD: 39.9 [33.6; 48.1] vs controls: 47.0 [39.9; 53.3]; P = 0.001), driven by reduced nighttime rMSSD (CHD: 43.5 [34.5; 55.3] vs controls: 53.1 [47.2; 65.4]; P < 0.001), with no significant daytime differences (CHD: 35.9 [31.8; 41.6] vs controls: 39.0 [32.3; 45.1]; P = 0.212). CHD showed a 17.4% higher HRV at night compared with the day, whereas controls exhibited a 46.4% increase, indicating significantly better autonomic recovery in controls during the night (P < 0.001). In patients, VO2 peak correlated positively with daytime (P < 0.001) and overall rMSSD (P = 0.017).
Conclusions:
Patients with CHD appear to have lower overall HRV, driven by decreased nighttime HRV compared with controls. Nighttime HRV is key for understanding recovery, sleep quality, and health. Continuous monitoring via health application programming interfaces could support reliable chronic health assessment and personalized care strategies.
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