{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:25:31Z","timestamp":1781753131492,"version":"3.54.5"},"reference-count":58,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T00:00:00Z","timestamp":1603238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Zukunftsfonds Steiermark","award":["ABT08-103259\/2018|PN:1018"],"award-info":[{"award-number":["ABT08-103259\/2018|PN:1018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Recent developments in noninvasive electrocardiogram (ECG) monitoring with small, wearable sensors open the opportunity to record high-quality ECG over many hours in an easy and non-burdening way. However, while their recording has been tremendously simplified, the interpretation of heart rate variability (HRV) data is a more delicate matter. The aim of this paper is to supply detailed methodological discussion and new data material in order to provide a helpful notice of HRV monitoring issues depending on recording conditions and study populations. Special consideration is given to the monitoring over long periods, across periods with different levels of activity, and in adults versus children. Specifically, the paper aims at making users aware of neglected methodological limitations and at providing substantiated recommendations for the selection of appropriate HRV variables and their interpretation. To this end, 30-h HRV data of 48 healthy adults (18\u201340 years) and 47 healthy toddlers (16\u201337 months) were analyzed in detail. Time-domain, frequency-domain, and nonlinear HRV variables were calculated after strict signal preprocessing, using six different high-frequency band definitions including frequency bands dynamically adjusted for the individual respiration rate. The major conclusion of the in-depth analyses is that for most applications that implicate long-term monitoring across varying circumstances and activity levels in healthy individuals, the time-domain variables are adequate to gain an impression of an individual\u2019s HRV and, thus, the dynamic adaptation of an organism\u2019s behavior in response to the ever-changing demands of daily life. The sound selection and interpretation of frequency-domain variables requires considerably more consideration of physiological and mathematical principles. For those who prefer using frequency-domain variables, the paper provides detailed guidance and recommendations for the definition of appropriate frequency bands in compliance with their specific recording conditions and study populations.<\/jats:p>","DOI":"10.3390\/s20205959","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T20:51:00Z","timestamp":1603399860000},"page":"5959","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["How to Use Heart Rate Variability: Quantification of Vagal Activity in Toddlers and Adults in Long-Term ECG"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0159-3720","authenticated-orcid":false,"given":"Helmut Karl","family":"Lackner","sequence":"first","affiliation":[{"name":"Division of Physiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria"},{"name":"Institute of Medical Engineering, Graz University of Technology, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Tanja Waltraud","family":"Eglmaier","sequence":"additional","affiliation":[{"name":"Division of Physiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria"},{"name":"Department of Psychology, Educational Psychology Unit, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"Hackl-Wimmer","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Psychology Unit, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Paechter","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Psychology Unit, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3195-4555","authenticated-orcid":false,"given":"Christian","family":"Rominger","sequence":"additional","affiliation":[{"name":"Division of Physiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2375-8952","authenticated-orcid":false,"given":"Lars","family":"Eichen","sequence":"additional","affiliation":[{"name":"Department of Early Childhood Education, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoline","family":"Rettenbacher","sequence":"additional","affiliation":[{"name":"Department of Early Childhood Education, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Walter-Laager","sequence":"additional","affiliation":[{"name":"Department of Early Childhood Education, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6620-0318","authenticated-orcid":false,"given":"Ilona","family":"Papousek","sequence":"additional","affiliation":[{"name":"Department of Psychology, Biological Psychology Unit, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mohino-Herranz, I., Gil-Pita, R., Rosa-Zurera, M., and Seoane, F. (2019). Activity Recognition Using Wearable Physiological Measurements: Selection of Features from a Comprehensive Literature Study. Sensors, 19.","DOI":"10.3390\/s19245524"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00421-010-1415-9","article-title":"Comparison of three mobile devices for measuring R\u2013R intervals and heart rate variability: Polar S810i, Suunto t6 and an ambulatory ECG system","volume":"109","author":"Weippert","year":"2010","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3389\/fpubh.2017.00258","article-title":"An Overview of Heart Rate Variability Metrics and Norms","volume":"5","author":"Shaffer","year":"2017","journal-title":"Front. Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0169-2607(98)00004-2","article-title":"POLYAN: A computer program for polyparametric analysis of cardio-respiratory variability signals","volume":"56","author":"Maestri","year":"1998","journal-title":"Comput. Methods Prog. Biomed."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cmpb.2009.10.002","article-title":"KARDIA: A Matlab software for the analysis of cardiac interbeat intervals","volume":"98","author":"Perakakis","year":"2010","journal-title":"Comput. Methods Prog. Biomed."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.cmpb.2013.07.024","article-title":"Kubios HRV\u2014Heart rate variability analysis software","volume":"113","author":"Tarvainen","year":"2014","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_7","first-page":"1","article-title":"HRVTool\u2014An Open-Source Matlab Toolbox for Analyzing Heart Rate Variability","volume":"46","author":"Vollmer","year":"2019","journal-title":"Comput. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3389\/fphys.2011.00086","article-title":"Heart rate variability\u2014A historical perspective","volume":"2","author":"Billman","year":"2011","journal-title":"Front. Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.3389\/fphys.2019.01265","article-title":"Editorial: Heart Rate Variability and Other Autonomic Markers in Children and Adolescents","volume":"10","author":"Billman","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3389\/fphys.2014.00073","article-title":"Monitoring training status with HR measures: Do all roads lead to Rome?","volume":"5","author":"Buchheit","year":"2014","journal-title":"Front. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1203\/00006450-198909000-00004","article-title":"Heart rate variability analysis in full-term infants: Spectral indices for study of neonatal cardiorespiratory control","volume":"26","author":"Baldzer","year":"1989","journal-title":"Pediatr. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/apa.14470","article-title":"Heart rate, respiratory rate, apnoeas and peripheral arterial oxygen saturation in healthy term neonates during quiet sleep","volume":"108","author":"Bohnhorst","year":"2019","journal-title":"Acta Paediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.biopsycho.2013.04.011","article-title":"Cardiac vagal control and children\u2019s adaptive functioning: A meta-analysis","volume":"94","author":"Graziano","year":"2013","journal-title":"Biol. Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1007\/s00421-012-2572-9","article-title":"Determinants and reference values of short-term heart rate variability in children","volume":"113","author":"Michels","year":"2013","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/cpf.12096","article-title":"Normal values for heart rate variability parameters in children 6\u20138 years of age: The PANIC Study","volume":"34","author":"Laitinen","year":"2014","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"582","DOI":"10.3389\/fphys.2017.00582","article-title":"A meta-analysis on sex differences in resting-state vagal activity in children and adolescents","volume":"8","author":"Koenig","year":"2017","journal-title":"Front. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/1098-2302(200007)37:1<44::AID-DEV6>3.0.CO;2-7","article-title":"Developmental changes in heart period and high-frequency heart period variability from 4 months to 4 years of age","volume":"37","author":"Marshall","year":"2000","journal-title":"Dev. Psychobiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/dev.20020","article-title":"Cardiac vagal regulation across the preschool period: Stability, continuity, and implications for childhood adjustment","volume":"45","author":"Calkins","year":"2004","journal-title":"Dev. Psychobiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/dev.21100","article-title":"Developmental trajectories of respiratory sinus arrhythmia: Associations with social responsiveness","volume":"56","author":"Patriquin","year":"2014","journal-title":"Dev. Psychobiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Task Force of ESC, and NASPE (1996). Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Circulation, 93, 1043\u20131065.","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3389\/fpsyg.2017.00213","article-title":"Heart Rate Variability and Cardiac Vagal Tone in Psychophysiological Research\u2014Recommendations for Experiment Planning, Data Analysis, and Data Reporting","volume":"8","author":"Laborde","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3389\/fphys.2012.00148","article-title":"Role of editing of R-R intervals in the analysis of heart rate variability","volume":"3","author":"Peltola","year":"2012","journal-title":"Front. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1469-8986.2005.00277.x","article-title":"Filter properties of root mean square successive difference (RMSSD) for heart rate","volume":"42","author":"Berntson","year":"2005","journal-title":"Psychophysiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1126\/science.6166045","article-title":"Power spectrum analysis of heart rate fluctuation: A quantitative probe of beat to beat cardiovascular control","volume":"213","author":"Akselrod","year":"1981","journal-title":"Science"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/j.1469-8986.1997.tb02140.x","article-title":"Heart rate variability: Origins, methods, and interpretive caveats","volume":"34","author":"Berntson","year":"1997","journal-title":"Psychophysiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1152\/japplphysiol.91107.2008","article-title":"Point: Respiratory sinus arrhythmia is due to a central mechanism","volume":"106","author":"Eckberg","year":"2009","journal-title":"J. Appl. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1152\/japplphysiol.91107.2008a","article-title":"Counterpoint: Respiratory sinus arrhythmia is due to the baroreflex mechanism","volume":"106","author":"Karemaker","year":"2009","journal-title":"J. Appl. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1109\/10.959330","article-title":"Do existing measures of Poincar\u00e9 plot geometry reflect nonlinear features of heart rate variability","volume":"48","author":"Brennan","year":"2001","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1002\/mus.25573","article-title":"Reminder: RMSSD and SD1 are identical heart rate variability metrics","volume":"56","author":"Ciccone","year":"2017","journal-title":"Muscle Nerve"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1111\/j.1469-8986.1981.tb03045.x","article-title":"Detection and recovery from errors in cardiac interbeat intervals","volume":"18","author":"Cheung","year":"1981","journal-title":"Psychophysiology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/j.1469-8986.1990.tb01982.x","article-title":"An Approach to Artifact Identification: Application to Heart Period Data","volume":"27","author":"Berntson","year":"1990","journal-title":"Psychophysiology"},{"key":"ref_32","first-page":"113","article-title":"Derivation of respiratory signals from multi-lead ECGs","volume":"12","author":"Moody","year":"1985","journal-title":"Comput. Cardiol."},{"key":"ref_33","first-page":"668","article-title":"Developmental changes in autonomic nervous system resting and reactivity measures in Latino children from 6 to 60 months of age","volume":"32","author":"Alkon","year":"2011","journal-title":"JDBP"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Alkon, A., Boyce, W.T., Tran, L., Harley, K.G., Neuhaus, J., and Eskenazi, B. (2014). Prenatal adversities and Latino children\u2019s autonomic nervous system reactivity trajectories from 6 months to 5 years of age. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0086283"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"467","DOI":"10.3389\/fphys.2018.00467","article-title":"Heart rate variability during a joint attention task in toddlers with autism spectrum disorders","volume":"9","author":"Billeci","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/dev0000894","article-title":"Developmental patterns of respiratory sinus arrhythmia from toddlerhood to adolescence","volume":"56","author":"Dollar","year":"2020","journal-title":"Dev. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"37212","DOI":"10.1038\/srep37212","article-title":"Resting-state high-frequency heart rate variability is related to respiratory frequency in individuals with severe mental illness but not healthy controls","volume":"6","author":"Quintana","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S0140-6736(10)62226-X","article-title":"Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: A systematic review of observational studies","volume":"9770","author":"Fleming","year":"2011","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3389\/fcvm.2020.00019","article-title":"The Inconsistent Nature of Heart Rate Variability During Sleep in Normal Children and Adolescents","volume":"7","author":"Kontos","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.cmpb.2010.11.011","article-title":"Effect of missing RR-interval data on nonlinear heart rate variability analysis","volume":"106","author":"Kim","year":"2012","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Morelli, D., Rossi, A., Cairo, M., and Clifton, D.A. (2019). Analysis of the Impact of Interpolation Methods of Missing RR-intervals Caused by Motion Artifacts on HRV Features Estimations. Sensors, 19.","DOI":"10.3390\/s19143163"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.ijpsycho.2011.01.001","article-title":"Phase synchronization of hemodynamic variables and respiration during mental challenge","volume":"79","author":"Lackner","year":"2011","journal-title":"Int. J. Psychophysiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"439","DOI":"10.33549\/physiolres.932603","article-title":"Multi-time scale perspective in analyzing cardiovascular data","volume":"63","author":"Lackner","year":"2014","journal-title":"Physiol. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.2147\/PRBM.S219784","article-title":"Influences of Different Dimensions of Academic Self-Concept on Students\u2019 Cardiac Recovery After Giving A Stressful Presentation","volume":"12","author":"Wimmer","year":"2019","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1109\/TBME.1986.325789","article-title":"An efficient algorithm for spectral analysis of heart rate variability","volume":"33","author":"Berger","year":"1986","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_46","unstructured":"Han, K., Nagel, J.H., and Schneiderman, N. (November, January 29). A Continuous Representation of Heart Rate. Proceedings of the 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Paris, France."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1088\/0967-3334\/23\/2\/308","article-title":"Study on the optimum order of autoregressive models for heart rate variability","volume":"23","author":"Boardman","year":"2002","journal-title":"Physiol. Meas."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.compbiomed.2011.11.004","article-title":"Spectral analysis of heart rate variability with the autoregressive method: What model order to choose?","volume":"42","author":"Dantas","year":"2012","journal-title":"Comput. Biol. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"5704","DOI":"10.1038\/s41598-020-62624-5","article-title":"A Comparative Study of ECG-derived Respiration in Ambulatory Monitoring using the Single-lead ECG","volume":"10","author":"Varon","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_50","first-page":"48","article-title":"Effects of Stimuli at Regular Intervals During Mental Stress on Cardiovascular Reactivity","volume":"24","author":"Lackner","year":"2010","journal-title":"J. Psychphys."},{"key":"ref_51","first-page":"27","article-title":"Die Koordination von Puls- und Atemrhythmus bei Arbeit","volume":"21","author":"Hildebrandt","year":"1965","journal-title":"Int. Z Angew. Physiol. Einschl. Arbeitsphysiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.3389\/fphys.2018.01495","article-title":"Normative Values for Heart Rate Variability Parameters in School-Aged Children: Simple Approach Considering Differences in Average Heart Rate","volume":"9","author":"Sacha","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1017\/S0954579417000669","article-title":"Quantifying respiratory sinus arrhythmia: Effects of misspecifying breathing frequencies across development","volume":"30","author":"Shader","year":"2018","journal-title":"Dev. Psychopathol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.biopsycho.2006.06.009","article-title":"The polyvagal perspective","volume":"74","author":"Porges","year":"2007","journal-title":"Biol. Psychol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1046\/j.1365-2281.2001.00337.x","article-title":"Time domain, geometrical and frequency domain analysis of cardiac vagal outflow: Effects of various respiratory patterns","volume":"21","author":"Helminen","year":"2001","journal-title":"Clin. Physiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/psyp.12027","article-title":"The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: A review with emphasis on a reanalysis of previous studies","volume":"50","author":"Langewitz","year":"2013","journal-title":"Psychophysiology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1007\/s11517-006-0119-0","article-title":"Heart rate variability: A review","volume":"44","author":"Kannathal","year":"2006","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"H2674","DOI":"10.1152\/ajpheart.2001.280.6.H2674","article-title":"Respiratory modulation of human autonomic rhythms","volume":"280","author":"Badra","year":"2001","journal-title":"Am. J. Physiol. Heart Circ. Physiol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/20\/5959\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:25:30Z","timestamp":1760178330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/20\/5959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,21]]},"references-count":58,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["s20205959"],"URL":"https:\/\/doi.org\/10.3390\/s20205959","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,21]]}}}