Ann Rehabil Med.  2017 Feb;41(1):129-137. 10.5535/arm.2017.41.1.129.

Accuracy of Heart Rate Measurement Using Smartphones During Treadmill Exercise in Male Patients With Ischemic Heart Disease

• Lee ES
• Lee JS
• Joo MC
• Kim JH
• Noh SE

• KMID: 2383687
• DOI: http://doi.org/10.5535/arm.2017.41.1.129

Abstract

OBJECTIVE
To evaluate the accuracy of a smartphone application measuring heart rates (HRs), during an exercise and discussed clinical potential of the smartphone application for cardiac rehabilitation exercise programs.
METHODS
Patients with heart disease (14 with myocardial infarction, 2 with angina pectoris) were recruited. Exercise protocol was comprised of a resting stage, Bruce stage II, Bruce stage III, and a recovery stage. To measure HR, subjects held smartphone in their hands and put the tip of their index finger on the built-in camera for 1 minute at each exercise stage such as resting stage, Bruce stage II, Bruce stage III, and recovery stage. The smartphones recorded photoplethysmography signal and HR was calculated every heart beat. HR data obtained from the smartphone during the exercise protocol was compared with the HR data obtained from a Holter electrocardiography monitor (control).
RESULTS
In each exercise protocol stage (resting stage, Bruce stage II, Bruce stage III, and the recovery stage), the HR averages obtained from a Holter monitor were 76.40±12.73, 113.09±14.52, 115.64±15.15, and 81.53±13.08 bpm, respectively. The simultaneously measured HR averages obtained from a smartphone were 76.41±12.82, 112.38±15.06, 115.83±15.36, and 81.53±13 bpm, respectively. The intraclass correlation coefficient (95% confidence interval) was 1.00 (1.00-1.00), 0.99 (0.98-0.99), 0.94 (0.83-0.98), and 1.00 (0.99-1.00) in resting stage, Bruce stage II, Bruce stage III, and recovery stage, respectively. There was no statistically significant difference between the HRs measured by either device at each stage (p>0.05).
CONCLUSION
The accuracy of measured HR from a smartphone was almost overlapped with the measurement from the Holter monitor in resting stage and recovery stage. However, we observed that the measurement error increased as the exercise intensity increased.

Keyword

Heart diseases; Rehabilitation; Heart rate; Smartphone; Exercise

MeSH Terms

Electrocardiography, Ambulatory
Fingers
Hand
Heart Diseases
Heart Rate*
Heart*
Humans
Male*
Myocardial Infarction
Myocardial Ischemia*
Photoplethysmography
Rehabilitation
Smartphone*

Figure

• 

  Fig. 1 Subjects' heart rates were measured at rest, during exercise at Bruce stage II, Bruce stage III, and during recovery stage using a smartphone and Holter monitor (GE Healthcare, Milwaukee, WI, USA).

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  Fig. 2 Atrial fibrillation diagnostic prototype application.

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  Fig. 3 Subjects held the smartphones in their hands and placed the index finger of their right hands on the camera of the smartphone for 1 minute.

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