Optically based wearable HR monitors showed variable accuracy compared to ECG depending on exercise type, with the Apple Watch having the best agreement among wrist devices (rc = 0.92).
Cross-Sectional (n=50)
Random assignment of wrist-worn monitors
Do optically based wearable heart rate monitors accurately measure heart rate compared to ECG during various types of aerobic exercise in healthy adults?
The accuracy of optically based wearable heart rate monitors varies significantly by device and exercise type, indicating that electrode-containing chest monitors should be used when precise heart rate measurement is required.
PURPOSE: Athletes and members of the public increasingly rely on wearable HR monitors to guide physical activity and training. The accuracy of newer, optically based monitors is unconfirmed. We sought to assess the accuracy of five optically based HR monitors during various types of aerobic exercise. METHODS: Fifty healthy adult volunteers (mean ± SD age = 38 ± 12 yr, 54% female) completed exercise protocols on a treadmill, a stationary bicycle, and an elliptical trainer (±arm movement). Each participant underwent HR monitoring with an electrocardiogaphic chest strap monitor (Polar H7), forearm monitor (Scosche Rhythm+), and two randomly assigned wrist-worn HR monitors (Apple Watch, Fitbit Blaze, Garmin Forerunner 235, and TomTom Spark Cardio), one on each wrist. For each exercise type, HR was recorded at rest, light, moderate, and vigorous intensity. Agreement between HR measurements was assessed using Lin's concordance correlation coefficient (rc). RESULTS: Across all exercise conditions, the chest strap monitor (Polar H7) had the best agreement with ECG (rc = 0.996) followed by the Apple Watch (rc = 0.92), the TomTom Spark (rc = 0.83), and the Garmin Forerunner (rc = 0.81). Scosche Rhythm+ and Fitbit Blaze were less accurate (rc = 0.75 and rc = 0.67, respectively). On treadmill, all devices performed well (rc = 0.88-0.93) except the Fitbit Blaze (rc = 0.76). While bicycling, only the Garmin, Apple Watch, and Scosche Rhythm+ had acceptable agreement (rc > 0.80). On the elliptical trainer without arm levers, only the Apple Watch was accurate (rc = 0.94). None of the devices was accurate during elliptical trainer use with arm levers (all rc < 0.80). CONCLUSION: The accuracy of wearable, optically based HR monitors varies with exercise type and is greatest on the treadmill and lowest on elliptical trainer. Electrode-containing chest monitors should be used when accurate HR measurement is imperative.
Gillinov et al. (Fri,) conducted a cross-sectional in Healthy adult volunteers (n=50). Optically based wearable HR monitors (Apple Watch, Fitbit Blaze, Garmin Forerunner 235, TomTom Spark Cardio, Scosche Rhythm+) vs. Electrocardiographic chest strap monitor (Polar H7) / ECG was evaluated on Agreement between HR measurements assessed using Lin's concordance correlation coefficient (rc). Optically based wearable HR monitors showed variable accuracy compared to ECG depending on exercise type, with the Apple Watch having the best agreement among wrist devices (rc = 0.92).