Heart Rate Variability and Wearable Devices: A Literature Review on Emerging Trends in Health Monitoring

Background and/or Objectives: Heart Rate Variability (HRV) is the fluctuation in the time interval between adjacent heartbeat, reflecting the dynamic balance between the sympathetic and parasympathetic nervous systems (Shaffer & Ginsberg, 2017). Higher HRV is generally considered to be better, as the heart is better able to adapt to physical, mental and environmental stressors (Tiwari et al., 2021). The rise of wearable devices has made HRV monitoring more accessible, offering a less invasive, cheaper, and more convenient alternative for continuous health tracking outside of a hospital or clinic (Sanches et al., 2023). With one in three adults in the United States using a wearable device, it is increasingly important to understand the potential implications and validity of these devices (Dhingra et al., 2023). HRV has been linked to various health conditions and, within these conditions, HRV can be a predictor of disease before disease onset and help to monitor disease progression (Tiwari et al., 2021; Wang et al., 2023; Young & Benton, 2018). Additionally, advancements in machine learning have enabled wearable devices to predict stress using physiological biomarkers. There is a growing consensus that machine learning and artificial intelligence can be used to predict stress using biomarkers from wearable devices (Faust et al., 2022; Vos et al., 2023).

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Interventions: This literature review is part of a larger study seeking to validate a new Apple Watch application against the 3-lead ECG over 5 minute intervals during sitting, walking, and continuous sit to stand.

Main Outcome Measures: This application is novel because it will utilize individualized norms to enhance the detection of true positives and will improve data analysis by excluding artifacts/outliers.

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Conclusions: The long-term goals of this project are to use machine learning to detect decreases in HRV (and therefore increased stress) and prompt the wearer to utilize relaxation techniques/coping strategies to normalize their HRV.