Validity of the Pneumonitor for RR intervals acquisition for short-term heart rate variability analysis extended with respiratory data in pediatric cardiac patients

Abstract

Background: Breathing pattern alterations change the variability and spectral content of the RR intervals (RRi) on electrocardiogram (ECG). However, there is no method to record and control participants’breathing without influencing its natural rate and depth in heart rate variability (HRV) studies. Aim: This study aimed to assess the validity of the Pneumonitor for acquisition of short-term (5 minutes) RRi in comparison to the reference ECG method for analysis of heart rate (HR) and HRV parameters in the group of pediatric patients with cardiac disease. Methods: Nineteen patients of both sexes participated in the study. An ECG and Pneumonitor were used to record RRi in 5-minute static rest conditions, the latter also to measure the relative tidal volume and respiratory rate. The validation comprised Student’s t-test, Bland-Altman analysis, intraclass correlation coefficient, and Lin’s concordance correlation. The possible impact of respiratory activity on the agreement between ECG and the Pneumonitor was also assessed. Results: An acceptable agreement for the number of RRi, mean RR, hazard ratio (HR), and HRV measures calculated based on RRi acquired using the ECG and Pneumonitor was presented. There was no association between the breathing pattern and RRi agreement between devices. Conclusions: The Pneumonitor might be considered appropriate for cardiorespiratory studies in the group of pediatric cardiac patients in rest condition.