Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment

The Kairos wristband offers on-demand heart rate variability (HRV) assessment through its “Spot Check” feature, enabling standardized recordings for clinical, research, or self-tracking purposes, but its validity is untested. Therefore, we compared the Kairos wristband to electrocardiography (ECG) f...

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Main Authors: Andrew A. Flatt, Ann Claire E. Blalock, Allison N. Wade, Bryan L. Riemann
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Sensors
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Online Access:https://www.mdpi.com/1424-8220/25/10/3165
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author Andrew A. Flatt
Ann Claire E. Blalock
Allison N. Wade
Bryan L. Riemann
author_facet Andrew A. Flatt
Ann Claire E. Blalock
Allison N. Wade
Bryan L. Riemann
author_sort Andrew A. Flatt
collection DOAJ
description The Kairos wristband offers on-demand heart rate variability (HRV) assessment through its “Spot Check” feature, enabling standardized recordings for clinical, research, or self-tracking purposes, but its validity is untested. Therefore, we compared the Kairos wristband to electrocardiography (ECG) for resting HRV assessment in young adults, and investigated the influence of skin pigmentation (M-index) on measurement accuracy. Simultaneous 3 min Kairos and ECG samples were obtained in the supine (n = 32) and seated (n = 30) position. Comparisons included resting heart rate (RHR) and time domain (root-mean square of successive differences [RMSSD], standard deviation of normal RR intervals [SDNN]), frequency domain (low [LF] and high frequency [HF]), and non-linear (standard deviation 1 [SD1] and SD2) HRV metrics. RHR showed excellent agreement whereas HF, LF, and SD2 showed poor agreement. For the remaining metrics, SDNN showed the strongest absolute and relative agreement, followed by SD1 and RMSSD. However, most HRV metrics exhibited heteroscedasticity or proportional bias, with greater error and underestimation at higher HRV values. M-index was unrelated to method difference scores, except for seated SD2 (<i>p</i> = 0.01). The Kairos wristband can be used to measure RHR, but HRV assessment should be limited to SDNN for global variability and SD1 or RMSSD for cardiac–parasympathetic activity. However, these metrics should be interpreted within the level of agreement identified in this study, and with consideration of the observed trend of diminished accuracy with higher HRV values.
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spelling doaj-art-538fb3af0906478c96c5c48947fbaec02025-08-20T03:48:01ZengMDPI AGSensors1424-82202025-05-012510316510.3390/s25103165Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability AssessmentAndrew A. Flatt0Ann Claire E. Blalock1Allison N. Wade2Bryan L. Riemann3Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Armstrong Campus, 11935 Abercorn St., Savannah, GA 31419, USABiodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Armstrong Campus, 11935 Abercorn St., Savannah, GA 31419, USABiodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Armstrong Campus, 11935 Abercorn St., Savannah, GA 31419, USABiodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Armstrong Campus, 11935 Abercorn St., Savannah, GA 31419, USAThe Kairos wristband offers on-demand heart rate variability (HRV) assessment through its “Spot Check” feature, enabling standardized recordings for clinical, research, or self-tracking purposes, but its validity is untested. Therefore, we compared the Kairos wristband to electrocardiography (ECG) for resting HRV assessment in young adults, and investigated the influence of skin pigmentation (M-index) on measurement accuracy. Simultaneous 3 min Kairos and ECG samples were obtained in the supine (n = 32) and seated (n = 30) position. Comparisons included resting heart rate (RHR) and time domain (root-mean square of successive differences [RMSSD], standard deviation of normal RR intervals [SDNN]), frequency domain (low [LF] and high frequency [HF]), and non-linear (standard deviation 1 [SD1] and SD2) HRV metrics. RHR showed excellent agreement whereas HF, LF, and SD2 showed poor agreement. For the remaining metrics, SDNN showed the strongest absolute and relative agreement, followed by SD1 and RMSSD. However, most HRV metrics exhibited heteroscedasticity or proportional bias, with greater error and underestimation at higher HRV values. M-index was unrelated to method difference scores, except for seated SD2 (<i>p</i> = 0.01). The Kairos wristband can be used to measure RHR, but HRV assessment should be limited to SDNN for global variability and SD1 or RMSSD for cardiac–parasympathetic activity. However, these metrics should be interpreted within the level of agreement identified in this study, and with consideration of the observed trend of diminished accuracy with higher HRV values.https://www.mdpi.com/1424-8220/25/10/3165wearable technologym-healthcardiovasculardevice validationautonomic nervous system
spellingShingle Andrew A. Flatt
Ann Claire E. Blalock
Allison N. Wade
Bryan L. Riemann
Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment
Sensors
wearable technology
m-health
cardiovascular
device validation
autonomic nervous system
title Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment
title_full Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment
title_fullStr Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment
title_full_unstemmed Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment
title_short Biostrap Kairos Wristband Versus Electrocardiography for Resting Heart Rate Variability Assessment
title_sort biostrap kairos wristband versus electrocardiography for resting heart rate variability assessment
topic wearable technology
m-health
cardiovascular
device validation
autonomic nervous system
url https://www.mdpi.com/1424-8220/25/10/3165
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