Work

Heart Rate Variability in Congenital Heart Disease and Controls Using Wearable Technology and a Health Application Programming Interface—A Cross-sectional Study

Year: 2025

Type: article

Abstract: Background With 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health conditions are associated with increased cardiac and psychological burdens, which could influence autonomic function. This study compares heart rate variability (HRV) levels between adults with CHD and controls. Methods Between September 2023 and February 2024, 124 adults with CHD (33.7 ± 10.5 years, 47.6% women) and 43 controls (34.3 ± 12.0 years, 44.2% women) participated in a wearable-based physiological assessment. HRV was continuously recorded using Garmin vivosmart 5 for 7 days, with data synchronized via a health application programming interface. The root mean square of successive differences (rMSSD) was calculated for day and nighttime based on individual sleep and waking schedules. Results Patients with CHD exhibited lower overall rMSSD than controls (CHD: 39.9 [33.6; 48.1] vs controls: 47.0 [39.9; 53.3]; P = 0.001), driven by reduced nighttime rMSSD (CHD: 43.5 [34.5; 55.3] vs controls: 53.1 [47.2; 65.4]; P < 0.001), with no significant daytime differences (CHD: 35.9 [31.8; 41.6] vs controls: 39.0 [32.3; 45.1]; P = 0.212). CHD showed a 17.4% higher HRV at night compared with the day, whereas controls exhibited a 46.4% increase, indicating significantly better autonomic recovery in controls during the night ( P < 0.001). In patients, VO 2 peak correlated positively with daytime ( P < 0.001) and overall rMSSD ( P = 0.017). Conclusions Patients with CHD appear to have lower overall HRV, driven by decreased nighttime HRV compared with controls. Nighttime HRV is key for understanding recovery, sleep quality, and health. Continuous monitoring via health application programming interfaces could support reliable chronic health assessment and personalized care strategies.

Source: CJC Pediatric and Congenital Heart Disease

DOI: 10.1016/j.cjcpc.2025.07.004

Authors: Charlotte Schöneburg, Isabel Uphoff, Renate Oberhoffer-Fritz, Peter Ewert, Jan Müller

Institutions: Technical University of Munich, TUM Klinikum, Deutsches Herzzentrum München

Language: English

Topic: Heart Rate Variability and Autonomic Control

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,100