Heart rate variability analysis during central hypovolemia using wavelet transformation

Soo Yeon Ji, Ashwin Belle, Kevin R. Ward, Kathy L. Ryan, Caroline A. Rickards, Victor A. Convertino, Kayvan Najarian

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Detection of hypovolemia prior to overt hemodynamic decompensation remains an elusive goal in the treatment of critically injured patients in both civilian and combat settings. Monitoring of heart rate variability has been advocated as a potential means to monitor the rapid changes in the physiological state of hemorrhaging patients, with the most popular methods involving calculation of the R-R interval signal's power spectral density (PSD) or use of fractal dimensions (FD). However, the latter method poses technical challenges, while the former is best suited to stationary signals rather than the non-stationary R-R interval. Both approaches are also limited by high inter- and intra-individual variability, a serious issue when applying these indices to the clinical setting. We propose an approach which applies the discrete wavelet transform (DWT) to the R-R interval signal to extract information at both 500 and 125 Hz sampling rates. The utility of machine learning models based on these features were tested in assessing electrocardiogram signals from volunteers subjected to lower body negative pressure induced central hypovolemia as a surrogate of hemorrhage. These machine learning models based on DWT features were compared against those based on the traditional PSD and FD, at both sampling rates and their performance was evaluated based on leave-one-subject- out fold cross-validation. Results demonstrate that the proposed DWT-based model outperforms individual PSD and FD methods as well as the combination of these two traditional methods at both sample rates of 500 Hz (p value <0.0001) and 125 Hz (p value <0.0001) in detecting the degree of hypovolemia. These findings indicate the potential of the proposed DWT approach in monitoring the physiological changes caused by hemorrhage. The speed and relatively low computational costs in deriving these features may make it particularly suited for implementation in portable devices for remote monitoring.

Original languageEnglish
Pages (from-to)289-302
Number of pages14
JournalJournal of Clinical Monitoring and Computing
Issue number3
StatePublished - Jun 2013


  • Discrete wavelet transformation
  • Heart rate variability (HRV)
  • Higuchi fractal dimension
  • Lower body negative pressure (LBNP)
  • Power spectral density
  • RR interval


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