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. 2005 Jan;10(1):7-15.
doi: 10.1111/j.1542-474X.2005.00579.x.

Heart rate variability fraction--a new reportable measure of 24-hour R-R interval variation

Maciej Sosnowski  1 , Elaine Clark, Shahid Latif, Peter W Macfarlane, Michal Tendera
Affiliations

Heart rate variability fraction--a new reportable measure of 24-hour R-R interval variation

Maciej Sosnowski et al. Ann Noninvasive Electrocardiol. 2005 Jan.

Abstract

Background: The scatterplot of R-R intervals has several unique features. Its numerical evaluation may produce a new useful index of global heart rate variability (HRV) from Holter recordings.

Methods: Two-hundred and ten middle-aged healthy subjects were enrolled in this study. The study was repeated the next day in 165 subjects. Each subject had a 24-hour ECG recording taken. Preprocessed data were transferred into a personal computer and the standard HRV time-domain indices: standard deviation of total normal R-R intervals (SDNN), standard deviation of averaged means of normal R-R intervals over 5-minute periods (SDANN), triangular index (TI), and pNN50 were determined. The scatterplot area (0.2-1.8 second) was divided into 256 boxes, each of 0.1-second interval, and the number of paired R-R intervals was counted. The heart rate variability fraction (HRVF) was calculated as the two highest counts divided by the number of total beats differing from the consecutive beat by <50 ms. The HRVF was obtained by subtracting this fraction from 1, and converting the result to a percentage.

Results: The normal value of the HRVF was 52.7 +/- 8.6%. The 2-98% range calculated from the normal probability plot was 35.1-70.3%. The HRVF varied significantly with gender (female 48.7 +/- 8.4% vs male 53.6 +/- 8.6%, P = 0.002). The HRVF correlated with RRI (r = 0.525) and showed a similar or better relationship with SDNN (0.851), SDANN (0.653), and TI (0.845) than did the standard HRV measures with each other. Bland-Altman plot showed a good day-by-day reproducibility of the HRVF, with the intraclass correlation coefficient of 0.839 and a low relative standard error difference (1.8%).

Conclusion: We introduced a new index of HRV, which is easy for computation, robust, reproducible, easy to understand, and may overcome the limitations that belong to the standard HRV measures. This index, named HRV fraction, by combining magnitude, distribution, and heart-rate influences, might become a clinically useful index of global HRV.

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Figures

Figure 1
Figure 1
Simplified view of a scatterplot of R‐R interval variation. Each square indicates the number (N) of pairs of successive R‐R intervals in a box of 0.1 s × 0.1 s grouped at different R‐R interval lengths (from 0.2 s up to 1.8 s). The two highest are easily seen as two black boxes, containing more than 20,000 pairs of R‐R intervals. These two counts are taken as figures N1 and N2 for the HRVF calculation.
Figure 2
Figure 2
Relationship between HRVF and standard HRV measures. Raw HRVF data and log‐transformed standard HRV measures were drawn for plots and calculations.
Figure 3
Figure 3
Bland‐Altman plots of reproducibility of all analyzed measures. Mean values shown in plots indicate mean difference between two day‐by‐day measurements, +1.96 × SD and –1.96 × SD values are also shown.
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