Key result
PPG-derived PRV yields ~0.19 absolute standardized error for RMSSD compared to ECG-derived HRV.
Why the study?
PPG-derived PRV is increasingly used as an alternative to ECG-derived HRV, but its agreement with ECG-derived measurements remains uncertain.
Does Photoplethysmography-derived pulse rate variability accurately measure heart rate variability compared to Electrocardiography in healthy populations?
Comparison
PPG-derived PRV vs ECG-derived HRV
Design
Systematic review and meta-analysis
Authors
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Clinicians should prefer ECG-HRV for precise autonomic assessment; meta-analysis challenges PPG-PRV equivalence even in healthy adults.
Meta-Analysis (n=43)
Does Photoplethysmography-derived pulse rate variability accurately measure heart rate variability compared to Electrocardiography in healthy populations?
Effect estimate: pooled absolute standardized error 0.188 (95% CI 0.066 to 0.309)
PPG-derived PRV shows reasonable agreement with ECG-derived HRV for RMSSD and SDNN under resting conditions, but cannot be assumed interchangeable in free-living or stress settings.
Xu et al. (2026) conducted a meta-analysis in Healthy or apparently healthy non-clinical populations (n=43). Photoplethysmography-derived pulse rate variability (PPG-derived PRV) vs. Electrocardiography-derived heart rate variability (ECG-derived HRV) was evaluated on Accuracy of RMSSD (root mean square of successive differences) (pooled absolute standardized error 0.188, 95% CI 0.066 to 0.309). Photoplethysmography-derived PRV showed a pooled absolute standardized error of 0.188 (95% CI 0.066-0.309) for RMSSD compared with electrocardiography-derived HRV in healthy populations.
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