Time and Frequency domain analysis of Heart Rate Variability

Archana Tatavarti
Instrumentation Department
BITS Pilani
f2013256@pilani.bits-pilani.ac.in

AbstractElectrocardiogram (ECG) is one of the most
important physiological parameter that gives correct
assessment of heart function. QRS complex is a prominent
waveform in an ECG that provides the basis for analyzing
heart rate variability (HRV). HRV refers to the beat-to-beat
alterations in heart rate. Commercial devices these days
provide preset computerized measurement of HRV, thus
providing the cardiologist a simple tool for both research
and clinical learning. To obtain meaningful data from the
ECG, a noise free inter-beat interval (IBI) time series is
required to be extracted. This is realized using standard
peak detection algorithms packed with data acquisition
hardware and software. The aim of this paper is to describe
various QRS detection methods used to derive HRV. It also
reviews various time and frequency domain HRV
parameters. The significance and meaning of these different
measures of HRV are a potential area of research.
Keywords- Heart rate, Heart Rate Variability - HRV, ECG ,
RR interval
I. INTRODUCTION
The electrocardiograms (ECG) give cardiac
functional details and helps in analyzing heart
abnormalities. Corresponding to every heart
beat in the ECG signal, a quasi-periodic
sequence of P, QRS and T- wave can be
observed. The QRS complex in this sequence
has the highest amplitude and once detected
helps in calculating the intervals between two
consecutive RR peaks. The variation in these
RR intervals is referred to as the Heart Rate
Variability (HRV). QRS detection therefore
provides the fundamental for almost all
automated ECG analysis algorithms. Several
algorithms for recognition of QRS complexes
are reported in literatures based on Pattern
recognition , Hilbert transform , Wavelet
transform , Neuro-fuzzy technique, Filtering
method , Derivative based algorithms etc.
For a regular cardiac system, the heart rate may
vary due to age, cardiac disease, neuropathy,
respiration, maximum inhalation and cardiac
load . Heart Rate Variability has become the
universally approved term to define variations
of both instantaneous heart rate and RR
intervals. Therefore HRV may be used as a
clinical and cost effective method to assess a
patients cardiac details. This paper reviews the
basics of Heart Rate Variability and standard
measurement techniques to detect QRS
complexes from ECG waveforms. It also
discusses various time and frequency domain
parameters used for analyzing HRV.
Variation in the beat-to-beat interval is a
physiological phenomenon. The SA
node receives several different inputs and the
instantaneous heart rate or RR interval and its
variation are the results of these inputs.
The main inputs are the sympathetic and
the parasympathetic nervous system (PSNS)
and humoral factors. Respiration gives rise to
waves in heart rate mediated primarily via the
PSNS, and it is thought that the lag in
the baroreceptor feedback loop may give rise to
10 second waves in heart rate (associated
with Mayer waves of blood pressure), but this
remains controversial.
Factors that affect the input are
the baroreflex, thermoregulation, hormones, slee
p-wake cycle, meals, physical activity,
and stress.
Decreased PSNS activity or increased SNS
activity will result in reduced HRV. High
frequency (HF) activity (0.15 to 0.40 Hz),
especially, has been linked to PSNS activity.
Activity in this range is associated with the
respiratory sinus arrhythmia (RSA), a vagally
mediated modulation of heart rate such that it
increases during inspiration and decreases
during expiration. Less is known about the
physiological inputs of the low frequency (LF)
activity (0.04 to 0.15 Hz). Though previously
thought to reflect SNS activity, it is now widely
accepted that it reflects a mixture of both the
SNS and PSNS.
Heart rate variability (HRV) is a measure of the
balance between sympathetic mediators of heart
rate that is the effect of epinephrine and
norepinephrine released from sympathetic nerve
fibres acting on the sino-atrial and atrio-
ventricular nodes which increase the rate of
cardiac contraction and facilitate conduction at
the atrio-ventricular node and parasympathetic
mediators of heart rate that is the influence of
acetylcholine released by the parasympathetic
nerve fibres acting on the sino-atrial and atrio-
ventricular nodes leading to a decrease in the
heart rate and a slowing of conduction at the
atrio-ventricular node.
Sympathetic mediators appear to exert their
influence over longer time periods and are
reflected in the low frequency power(LFP) of
the HRV spectrum (between 0.04Hz and 0.15
Hz).Vagal mediators exert their influence more
quickly on the heart and principally affect the
high frequency power (HFP) of the HRV
spectrum (between 0.15Hz and 0.4 Hz). Thus at
any point in time the LFP:HFP ratio is a proxy
for the sympatho- vagal balance. Thus HRV is a
valuable tool to investigate the sympathetic and
parasympathetic function of the autonomic
nervous system. Study of HRV enhance our
understanding of physiological phenomenon,
the actions of medications and disease
mechanisms but large scale prospective studies
are needed to determine the sensitivity,
specificity and predictive values of heart rate
account. If the spectrum estimate is
calculated from this irregularly time-sampled
signal, additional harmonic components appear
in the spectrum. Therefore, the RR interval
variability regarding death or morbidity in
cardiac and non-cardiac patients.
II. LITERATURE REVIEW
A. Definition
The interval between adjacent QRS
complexes is termed as the normal to normal
(NN) or the R to R (RR) intervals. Heart rate
variability (HRV) refers to the beat-to-beat
alterations in heart rate. Under resting
conditions, the ECG of healthy individuals
exhibits periodic variation in R-R intervals. The
HRV measurements are captured non-invasively
from the ECG signal. The results from this HRV
data are capable of portraying physiological
condition of the patient and are an important
indicator of cardiac disease. Variability in heart
rate is clinically linked to lethal arrhythmias,
hypertension, coronary artery disease,
congestive heart failure, organ transplant,
tachycardia, neuropathy, and diabetes.
Methods used to detect beats include: ECG,
blood pressure, ballistocardiograms, and the
pulse wave signal derived from
a photoplethysmograph (PPG). ECG is
considered superior because it provides a clear
waveform, which makes it easier to exclude
heartbeats not originating in the sinoatrial node.
The term "NN" is used in place of RR to
emphasize the fact that the processed beats are
"normal" beats.
Frequency Domain Analysis:
In contrast to the time domain measures of
HRV mentioned above, recent developments in
microprocessor technology has enabled the
calculation of frequency measures on the same
ECG data. Frequency measures involve the
spectral analysis of HRV. The RR interval time
series is an irregularly time-sampled signal. This
is not an issue in time domain, but in the
frequency-domain it has to be taken into
signal is usually interpolated before the spectral
analysis to recover an evenly sampled signal
from the irregularly sampled event series. The
HRV spectrum contains the high frequency
(0.18 to 0.4 Hz) component, which is due to
respiration and the low frequency (0.04 to 0.15
Hz) component that appears due to both the
vagus and cardiac sympathetic nerves. Ratio of
the low-to-high frequency spectra is used as an
index of parasympathetic-sympathetic balance.
Frequency domain HRV variables are detailed
in Table II
In the frequency-domain analysis power spectral
density (PSD) of the RR series is calculated.
Methods for calculating the PSD may be
divided into Fast Fourier transform (FFT) based
and autoregressive (AR) model based methods.
The PSD is analyzed by calculating powers and
peak frequencies for different frequency bands.
For the FFT based spectrum analysis powers are
calculated by integrating the entire spectrum.
The spectrum in AR model methods can be
divided into components and the band powers
are obtained as powers of these components .
IV. DISCUSSIONS
Duration and magnitude of QRS waves are
the essence of HRV. Therefore, precise RR
intervals calculations are necessary to accurately
depict the physiological state. The smaller the
standard deviation in R-R intervals, the lower is
the HRV. To date, over 26 different types of
arithmetic manipulations of R-R intervals have
been used in the literature to represent HRV.
The accuracy of the R-wave occurrence time
estimates is often required to be about 1 ms and
thus, the sampling frequency of the ECG should
be at least 500 Hz . If the sampling frequency of
the ECG is less than 500 Hz, the errors in R-
wave occurrence times can cause critical
distortion to HRV analysis results, especially to
spectrum estimates
Several studies propose a link between negative
emotions (such as anxiety and hostility) and
reduced HRV. In normal subjects, both
sympathetic and parasympathetic tone fluctuates
throughout the day. It is also rate dependent i.e.
the HRV is more at lower heart rates. HRV is
sensitive and responsive to acute stress. Mental
load like making complex decisions have been
shown to lower HRV. Resting heart rate does not
change significantly with advancing age, but
there is a decline in HRV and for an individual,
the HRV is highest during sleep. Regular
physical activity however has been shown to
raise HRV.
On reducing the monitoring period, the
frequency domain HRV parameter SDNN takes
shorter cycle lengths. The total variance of HRV
however, increases with the length of recording
being analyzed . Thus, on arbitrarily selected
ECG data, SDNN and similarly other frequency
domain parameters are not well defined
statistical quantity because of their dependence
on the length of recording period. However,
short-term 5-min recordings and nominal 24 h
long-term recordings appear to be suitable
options.
Distinct spectral variations can be detected in
human subjects in varying postures or body
angle. HRV studies of subjects on a tilt table can
produce information about sympathetic and
parasympathetic regulation of cardiac cycle.
Short term HRV may describe increased or
decreased autonomic adaptation to stimuli.
Power spectrum analysis of HRV may describe
the extent of sympathetic and vagal adaptation
in patients. HRV data analysis provides
additional insight into cardio-pathologies,
thereby assisting physicians who desire speedy
diagnosis provided by non-invasive means.
DESIGN
Heart rate Variability (HRV) signals, which
represent the physiological variation in time
between heartbeats, are typically unevenly
sampled because human heart rates are not
constant. HRV signals are derived from
electrocardiogram (ECG) readings.
The sample points of an HRV signal are located
at the R-Peak times of the ECG. The amplitude
of each point is computed as the inverse of the
time difference between consecutive R-Peaks
and is placed at the instant of the second R-
Peak.
The varying intervals between the R-peaks
cause the sample-time nonuniformity in the
HRV data. Consider the peak locations of the
signal and plot a histogram of their separations
in seconds.
The typical frequency bands of interest in HRV
spectra are:
Very Low Frequency (VLF), from 3.3 to
40 mHz,
Low Frequency (LF), from 40 to 150
mHz,
High Frequency (HF), from 150 to 400
mHz.
These bands approximately confine the
frequency ranges of the distinct biological
regulatory mechanisms that contribute to HRV.
Fluctuations in any of these bands have
biological significance.
The dashed lines denote 95% and 50% detection
probabilities. These thresholds measure the
statistical significance of peaks. The spectrum
shows peaks in all three bands of interest listed
FUTURE POSSIBILITIES
Development of HRV measurement:
The currently available timedomain methods
predominantly used to assess the long-term
profile of HRV are probably sufficient for this
purpose. Improvements are possible, especially
in terms of numerical robustness. The
contemporary non-parametric and parametric
spectral methods are probably sufficient to
analyse short-term ECGs without transient
changes of heart period modulations. Apart
from the need to develop numerically robust
techniques suitable for fully automatic
measurement (the geometrical methods are only
one possibility in this direction), the following
three areas deserve attention.
Dynamics and transient changes of HRV:
The present possibilities of characterizing the
quantifying the dynamics of the RR interval
sequence and transient changes of HRV are
sparse and still under mathematical
development. However, it may be assumed that
proper assessment of HRV dynamics will lead
to substantial improvements in our
understanding of both the modulations of heart
period and their physiological and
pathophysiological correlates
It remains to be seen whether the methods of
non-linear dynamics will be appropriate for the
measurement of transient changes in RR
intervals or whether new mathematical models
and algorithmic concepts will be needed to
tailor the principles of measurement more
closely to the physiological nature of cardiac
periodograms. In any case, the task of assessing
above. However, only the peak located at 23.2
mHz in the VLF range shows a detection
probability 95%, while the other peaks have
detection probabilities of less than 50%. The
peaks lying below 40 mHz are thought to be due
to long-term regulatory mechanisms, such as the
thermoregulatory system and hormonal factors.
transient changes in HRV seems to be more
important than further refinements of the current
technology used to analyse stable stages of heart
period modulations.
PP and RR intervals :
Little is known about the interplay between the
PP and PR autonomic modulations. For these
reasons, the sequence of PP intervals should also
be studied[168]. Unfortunately, precise location
of a P wave fiducial point is almost impossible
to achieve in surface ECGs recorded with the
current technology. However, developments in
the technology should allow PP interval and PR
interval variability to be investigate in future
studies.
Multisignal analysis:
The modulations of heart periods are naturally
not the only manifestation of the autonomic
regulatory mechanisms. Currently, commercial
or semi-commercial equipment exists which
enables simultaneous recording of ECG,
respiration, blood pressure, etc. However, in
spite of the ease with which the signals can be
recorded, no widely accepted method exists for
comprehensive multisignal analysis. Each signal
can be analysed separately, e.g. with parametric
spectral methods, and the results of the analysis
compared. Analysis of coupling between
physiological signals allow the properties of the
coupling to be measured
V. CONCLUSIONS
The analysis of HRV both by time-domain
and spectral approaches offer a non-invasive
method of evaluating cardiac functioning. The
measurement of HRV is becoming increasingly
standardized. The major reason for the interest
in measuring HRV stems from its ability to
predict survival after heart attack. Many studies
have shown that reduced HRV predicts sudden
death in patients. Although, the assessment of
HRV requires expertise, the equipment is not
expensive, requiring only ECG equipment,
microprocessors, and relevant software for
carrying out time and frequency domain
analyses. So far, experimental and simulation
data appear to indicate that the various methods
of expressing HRV are largely equivalent, and
there is no evidence that any one method is
superior to another, provided measurement
windows are 5 minutes or longer.