A Combined Syntactical and Statistical Approach for R Peak Detection in Real-Time Long-Term Heart Rate Variability Analysis

Long-term heart rate variability (HRV) analysis is useful as a noninvasive technique for autonomic nervous system activity assessment. It provides a method for assessing many physiological and pathological factors that modulate the normal heartbeat. The performance of HRV analysis systems heavily depends on a reliable and accurate detection of the R peak of the QRS complex. Ectopic beats caused by misdetection or arrhythmic events can introduce bias into HRV results, resulting in significant problems in their interpretation. This study presents a novel method for long-term detection of normal R peaks (which represent the normal heartbeat in electrocardiographic signals), intended specifically for HRV analysis. The very low computational complexity of the proposed method, which combines and exploits the advantages of syntactical and statistical approaches, enables real-time applications. The approach was validated using the Massachusetts Institute of Technology–Beth Israel Hospital Normal Sinus Rhythm and the Fantasia database, and has a sensitivity, positive predictivity, detection error rate, and accuracy of 99.998, 99.999, 0.003, and 99.996%, respectively.