Quantification of error between the heartbeat intervals measured form photoplethysmogram and electrocardiogram by synchronisation

Validation of Photoplethysmography Using a Mobile Phone Application for the Assessment of Heart Rate Variability in the Context of Heart Rate Variability-Biofeedback

OBJECTIVE

Heart rate variability-biofeedback (HRV-BF) is an effective intervention to reduce stress and anxiety and requires accurate measures of real-time HRV. HRV can be measured through photoplethysmography (PPG) using the camera of a mobile phone. No studies have directly compared HRV-BF supported through PPG against classical electrocardiogram (ECG). The current study aimed to validate PPG HRV measurements during HRV-BF against ECG.

METHODS

Fifty-seven healthy participants (70% women) with a mean (standard deviation) age of 26.70 (9.86) years received HRV-BF in the laboratory. Participants filled out questionnaires and performed five times a 5-minute diaphragmatic breathing exercise at different paces (range, ~6.5 to ~4.5 breaths/min). Four HRV indices obtained through PPG, using the Happitech software development kit, and ECG, using the validated NeXus apparatus, were calculated and compared: RMSSD, pNN50, LFpower, and HFpower. Resonance frequency (i.e., optimal breathing pace) was also compared between methods.

RESULTS

All intraclass correlation coefficient values of the five different breathing paces were "near perfect" (>0.90) for all HRV indices: lnRMSSD, lnpNN50, lnLFpower, and lnHFpower. All Bland-Altman analyses (with just three incidental exceptions) showed good interchangeability of PPG- and ECG-derived HRV indices. No systematic evidence for proportional bias was found for any of the HRV indices. In addition, correspondence in resonance frequency detection was good with 76.6% agreement between PPG and ECG.

CONCLUSIONS

PPG is a potentially reliable and valid method for the assessment of HRV. PPG is a promising replacement of ECG assessment to measure resonance frequency during HRV-BF.

Application of photoplethysmography signals for healthcare systems: An in-depth review

BACKGROUND AND OBJECTIVES

Photoplethysmography (PPG) is a device that measures the amount of light absorbed by the blood vessel, blood, and tissues, which can, in turn, translate into various measurements such as the variation in blood flow volume, heart rate variability, blood pressure, etc. Hence, PPG signals can produce a wide variety of biological information that can be useful for the detection and diagnosis of various health problems. In this review, we are interested in the possible health disorders that can be detected using PPG signals.

METHODS

We applied PRISMA guidelines to systematically search various journal databases and identified 43 PPG studies that fit the criteria of this review.

RESULTS

Twenty-five health issues were identified from these studies that were classified into six categories: cardiac, blood pressure, sleep health, mental health, diabetes, and miscellaneous. Various routes were employed in these PPG studies to perform the diagnosis: machine learning, deep learning, and statistical routes. The studies were reviewed and summarized.

CONCLUSIONS

We identified limitations such as poor standardization of sampling frequencies and lack of publicly available PPG databases. We urge that future work should consider creating more publicly available databases so that a wide spectrum of health problems can be covered. We also want to promote the use of PPG signals as a potential precision medicine tool in both ambulatory and hospital settings.

Blue as an Underrated Alternative to Green: Photoplethysmographic Heartbeat Intervals Estimation under Two Temperature Conditions

Since photoplethysmography (PPG) sensors are usually placed on open skin areas, temperature interference can be an issue. Currently, green light is the most widely used in the reflectance PPG for its relatively low artifact susceptibility. However, it has been known that hemoglobin absorption peaks at the blue part of the spectrum. Despite this fact, blue light has received little attention in the PPG field. Blue wavelengths are commonly used in phototherapy. Combining blue light-based treatments with simultaneous blue PPG acquisition could be potentially used in patients monitoring and studying the biological effects of light. Previous studies examining the PPG in blue light compared to other wavelengths employed photodetectors with inherently lower sensitivity to blue, thereby biasing the results. The present study assessed the accuracy of heartbeat intervals (HBIs) estimation from blue and green PPG signals, acquired under baseline and cold temperature conditions. Our PPG system is based on TCS3472 Color Sensor with equal sensitivity to both parts of the light spectrum to ensure unbiased comparison. The accuracy of the HBIs estimates, calculated with five characteristic points (PPG systolic peak, maximum of the first PPG derivative, maximum of the second PPG derivative, minimum of the second PPG derivative, and intersecting tangents) on both PPG signal types, was evaluated based on the electrocardiographic values. The statistical analyses demonstrated that in all cases, the HBIs estimation accuracy of blue PPG was nearly equivalent to the G PPG irrespective of the characteristic point and measurement condition. Therefore, blue PPG can be used for cardiovascular parameter acquisition. This paper is an extension of work originally presented at the 42nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

An Exploration of Blue PPG Signal Using a Novel Color Sensorbased PPG System

Reflectance photoplethysmography is a widely employed method in personal health assessment devices. We developed a remote PPG system for obtaining the signal from palm skin. For the handle-mounted design, it is crucial to ensure accurate measurements under a range of skin temperatures. Under lower temperatures, green PPG was proven to provide superior signal quality in comparison to infrared PPG. However, since hemoglobin has maximum absorption in both green and blue parts of the spectrum, to ensure a stable performance of handle-mounted PPG system under different temperature conditions, it is worth exploring the PPG signal in both wavelengths. In our PPG system, TCS3472 Color Sensor was chosen as a photodetector. In distinction from video cameras with Bayer pattern, the TCS3472 has an equal number of R, G, and B sensing elements, thereby allowing the comparison of these wavelengths performance. Using the developed system, we compared green and blue PPG signals from six subjects in terms of amplitude and accuracy of heartbeat intervals estimation under two temperature conditions. According to our preliminary results, the performance of blue PPG was comparable to green PPG under both temperature conditions, suggesting further investigation with our system is worth conducting.