Heart rate variability (HRV) provides significant information about the health status of an individual. Optical heart rate monitoring is a comfortable alternative to ECG based heart rate monitoring. However, most available optical heart rate monitoring devices do not supply beat-to-beat detection accuracy required by proper HRV analysis. We evaluate the beat-to-beat detection accuracy of a recent wrist-worn optical heart rate monitoring device, PulseOn (PO). Ten subjects (8 male and 2 female; 35.9±10.3 years old) participated in the study. HRV was recorded with PO and Firstbeat Bodyguard 2 (BG2) device, which was used as an ECG based reference. HRV was recorded during sleep. As compared to BG2, PO detected on average 99.57% of the heartbeats (0.43% of beats missed) and had 0.72% extra beat detection rate, with 5.94 ms mean absolute error (MAE) in beat-to-beat intervals (RRI) as compared to the ECG based RRI BG2. Mean RMSSD difference between PO and BG2 derived HRV was 3.1 ms. Therefore, PO provides an accurate method for long term HRV monitoring during sleep.

Results suggest that wrist PPG measurement allows accurate HR and beat-to-beat HR monitoring also in AF patients, and could be used for differentiating between SR and AF with very good sensitivity.

PulseOn is a wrist-worn optical heart rate (HR) monitor based on photoplethysmography. It utilizes multi-wavelength technology and optimized sensor geometry to monitor blood flow at different depths of skin tissue, and it dynamically adapts to an optimal measurement depth in different conditions. Movement artefacts are reduced by adaptive movement-cancellation algorithms and optimized mechanics, which stabilize the sensor-to-skin contact. In this paper, we evaluated the accuracy and reliability of PulseOn technology against ECG-derived HR in laboratory conditions during a wide range of physical activities and also during outdoor sports. In addition, we compared the performance to another on-the-shelf wrist-worn consumer product Mio LINK(®). The results showed PulseOn reliability (% of time with error <;10bpm) of 94.5% with accuracy (100% - mean absolute percentage error) 96.6% as compared to ECG (vs 86.6% and 94.4% for Mio LINK(®), correspondingly) during laboratory protocol. Similar or better reliability and accuracy was seen during normal outdoor sports activities. The results show that PulseOn provides reliability and accuracy similar to traditional chest strap ECG HR monitors during cardiovascular exercise.

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