Applied Sciences
Inter-Lead RRI Agreement Between Lead I and Lead II Across Diagnostic ECG Categories: Pilot Evidence for Wearable HRV Monitoring
By Naoya Morikawa and Emi Yuda.
Abstract
Background
Wearable electrocardiogram (ECG) devices capable of recording a single-lead signal—typically Lead I—have proliferated rapidly, enabling long-term ambulatory cardiac monitoring outside clinical settings. However, the extent to which Lead I-derived heart rate variability (HRV) metrics are concordant with those obtained from the clinical gold standards—12-lead ECG and 3-channel Holter monitoring—remains incompletely characterised.
Methods
We analysed RR-interval series extracted from (i) the PTB-XL large-scale publicly available 12-lead ECG dataset (n = 18,869 patients; 100 Hz, 10 s recordings) and (ii) ambulatory 3-channel Holter ECG recordings (Suzuken Pico303) from four participants (two elderly adults and two young adults). Pan–Tompkins R-wave detection was applied uniformly. Time-domain (SDNN, RMSSD, and pNN50), Poincaré (SD1 and SD2), and Bland–Altman agreement metrics were computed for Lead I versus Lead II comparisons.