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Vol. 22. Num. 5.01 September 2018
Pages 345-434
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Vol. 22. Num. 5.01 September 2018
Pages 345-434
Original Research
DOI: 10.1016/j.bjpt.2018.03.008
Can RR intervals editing and selection techniques interfere with the analysis of heart rate variability?
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Gustavo dos Santos Ribeiroa, Victor Ribeiro Nevesb, Luís Fernando Dereszc, Rosangela Domingues Meloa, Pedro Dal Lagoa,d, Marlus Karstena,e,f,
Corresponding author
marlus.karsten@udesc.br

Corresponding author at: Universidade do Estado de Santa Catarina, Centro de Ciência da Saúde e do Esporte, Rua Pascoal Simone, 358, CEP: 88080-350, Florianópolis, SC, Brazil.
a Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
b Department of Physical Therapy, Universidade de Pernambuco – Campus Petrolina (UPE), Petrolina, PE, Brazil
c Department of Physical Education, Universidade Federal de Juiz de Fora (UFJF), Govenador Valadares, MG, Brazil
d Department of Physical Therapy, UFCSPA, Porto Alegre, RS, Brazil
e Department of Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil
f Graduate Program in Physical Therapy, UDESC, Florianópolis, SC, Brazil
Highlights

  • 95% confidence interval identified more doubtful points than other studied methods.

  • Correction techniques do not influence the final set of RR intervals.

  • Selection methods may interfere with the quantity–quality of RR intervals.

  • The 256-point selection appears to be more sensitive to changes in autonomic function.

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Tables (3)
Table 1. Characteristics of the 3 heart rate analysis groups: aortic stenosis patients (PTS), physically active subjects (PAS) and amateur running athletes (ARA).
Table 2. Linear methods of heart rate variability analyzed from the sample databases obtained from the selection of 256 highest stability points and the final 5min of the recording for the 3 heart rate analysis groups i.e. the cardiac patient group (PTS group), the physically active group (PAS group), and the athletic group (ARA group).
Table 3. Non-linear indices of heart rate variability analyzed from the databases of the 3 heart rate analysis groups obtained from the selection of 256 highest stability points and the final 5min of the record.
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Abstract
Background

Oscillation between successive sinus beats or RR intervals, termed heart rate variability, is an important marker of autonomic function of the heart. However, its analysis may be influenced by the database recorded based on the occurrence of interference.

Objective

To evaluate if the techniques of identification and editing of artifacts, as well as the selection methods of RR intervals, can interfere with heart rate variability analysis.

Methods

The RR intervals of 56 subjects (30 aortic stenosis patients, 14 physically active individuals, 12 amateur athletes) were recorded for 10min using a heart rate monitor. Values with differences greater than 20%, higher than three standard deviations or outside of the normal curve (95% confidence interval) were considered artifacts. These points were corrected through data replacement, adjacent, linear and polynomial interpolation, or excluded. Then, the 256 highest stability points and the last 5min of recordings were chosen. The software programs, Kubios HRV and GraphPAD, were used to calculate and to analyze the indices of heart rate variability, respectively.

Results

Strong agreement was observed among the identification algorithms; there was no difference between the correction techniques (p=0.95); and the selection methods exhibited different sections (p<0.01) with a direct influence on approximated entropy (p<0.05).

Conclusion

With short-term recordings, selection methods may interfere with the non-linear heart rate variability analysis. The confidence interval, the replacement by the average of previous data and the selection of 256 of the highest stability points of the signal seem to be the most adequate procedures to treat the data with prior to analysis.

Keywords:
Cardiovascular system
Autonomous nervous system
Premature ventricular complexes
Artifacts
Test reproducibility

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