TY  - JOUR
AU  - Mestrom, Eveline
AU  - Deneer, Ruben
AU  - Bonomi, Alberto G
AU  - Margarito, Jenny
AU  - Gelissen, Jos
AU  - Haakma, Reinder
AU  - Korsten, Hendrikus H M
AU  - Scharnhorst, Volkher
AU  - Bouwman, R Arthur
PY  - 2021
DA  - 2021/11/4
TI  - Validation of Heart Rate Extracted From Wrist-Based Photoplethysmography in the Perioperative Setting: Prospective Observational Study
JO  - JMIR Cardio
SP  - e27765
VL  - 5
IS  - 2
KW  - validation
KW  - heart rate
KW  - photoplethysmography
KW  - perioperative patients
KW  - unobtrusive sensing
AB  - Background: Measurement of heart rate (HR) through an unobtrusive, wrist-worn optical HR monitor (OHRM) could enable earlier recognition of patient deterioration in low acuity settings and enable timely intervention. Objective: The goal of this study was to assess the agreement between the HR extracted from the OHRM and the gold standard 5-lead electrocardiogram (ECG) connected to a patient monitor during surgery and in the recovery period. Methods: In patients undergoing surgery requiring anesthesia, the HR reported by the patient monitor’s ECG module was recorded and stored simultaneously with the photopletysmography (PPG) from the OHRM attached to the patient’s wrist. The agreement between the HR reported by the patient’s monitor and the HR extracted from the OHRM’s PPG signal was assessed using Bland-Altman analysis during the surgical and recovery phase. Results: A total of 271.8 hours of data in 99 patients was recorded simultaneously by the OHRM and patient monitor. The median coverage was 86% (IQR 65%-95%) and did not differ significantly between surgery and recovery (Wilcoxon paired difference test P=.17). Agreement analysis showed the limits of agreement (LoA) of the difference between the OHRM and the ECG HR were within the range of 5 beats per minute (bpm). The mean bias was –0.14 bpm (LoA between –3.08 bpm and 2.79 bpm) and –0.19% (LoA between –5 bpm to 5 bpm) for the PPG- measured HR compared to the ECG-measured HR during surgery; during recovery, it was –0.11 bpm (LoA between –2.79 bpm and 2.59 bpm) and –0.15% (LoA between –3.92% and 3.64%). Conclusions: This study shows that an OHRM equipped with a PPG sensor can measure HR within the ECG reference standard of –5 bpm to 5 bpm or –10% to 10% in the perioperative setting when the PPG signal is of sufficient quality. This implies that an OHRM can be considered clinically acceptable for HR monitoring in low acuity hospitalized patients. 
SN  - 2561-1011
UR  - https://cardio.jmir.org/2021/2/e27765
UR  - https://doi.org/10.2196/27765
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34734834
DO  - 10.2196/27765
ID  - info:doi/10.2196/27765
ER  -