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

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 hea...

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Vydáno v:CJC pediatric and congenital heart disease
Hlavní autoři: Schöneburg, Charlotte, Uphoff, Isabel, Oberhoffer-Fritz, Renate, Ewert, Peter, Müller, Jan
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Abstract 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. 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. 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, VO2 peak correlated positively with daytime (P < 0.001) and overall rMSSD (P = 0.017). 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. Aujourd’hui, 95 % des patients qui présentent une cardiopathie congénitale (CC) atteignent l’âge adulte, et l’intérêt se porte maintenant davantage sur la morbidité à long terme que sur la mortalité précoce. Or, les maladies chroniques sont associées à un risque plus élevé de problèmes cardiaques et psychologiques qui peuvent influer sur la fonction autonome. Nous comparons dans cette étude la variabilité de la fréquence cardiaque (VFC) chez des adultes atteints de CC à celle de sujets témoins. Entre septembre 2023 et février 2024, 124 adultes atteints de CC (33,7 ans ± 10,5 ans, 47,6 % de femmes) et 43 sujets témoins (34,3 ans ± 12 ans, 44,2 % de femmes) ont participé à une évaluation physiologique au moyen de la technologie portable. La VFC a été enregistrée en continu à l’aide de l’appareil vivosmart® 5 de Garmin pendant 7 jours. Une interface de programmation d’applications (API) en santé permettait de synchroniser les données. On a calculé la moyenne quadratique des écarts successifs entre les battements cardiaques (rMSSD) de jour et de nuit en fonction des cycles individuels de sommeil et d’éveil. Les patients atteints de CC affichaient une rMSSD globale inférieure à celle des témoins (CC : 39,9 [33,6; 48,1] vs témoins : 47,0 [39,9; 53,3]; p = 0,001), un résultat attribuable à une rMSSD nocturne basse (CC : 43,5 [34,5; 55,3] vs témoins : 53,1 [47,2; 65,4]; p < 0,001); les différences diurnes n’étaient pas significatives (CC : 35,9 [31,8; 41,6] vs témoins : 39,0 [32,3; 45,1]; p = 0,212). Chez les patients atteints de CC, la VFC était de 17,4 % plus élevée la nuit que le jour, alors que chez les témoins, la VFC était de 46,4 % plus élevée la nuit que le jour, signe d’une récupération de la fonction autonome significativement meilleure chez les témoins pendant la nuit (p < 0,001). Une corrélation positive entre la consommation maximale d’oxygène (VO2 max) et la rMSSD diurne (p < 0,001) et la rMSSD globale (p = 0,017) a été observée chez les patients. Les patients atteints de CC semblent avoir une VFC globale moindre, qui s’explique par une VFC nocturne basse comparativement à celle des témoins. La VFC nocturne est un paramètre essentiel pour la compréhension de la récupération, de la qualité du sommeil et de la santé. Une surveillance continue par des API en santé pourrait permettre une évaluation fiable au long cours de l’état de santé et servir de base à des stratégies personnalisées de prise en charge.
AbstractList AbstractBackgroundWith 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. MethodsBetween 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. ResultsPatients 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). ConclusionsPatients 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.
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. 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. 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, VO2 peak correlated positively with daytime (P < 0.001) and overall rMSSD (P = 0.017). 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. Aujourd’hui, 95 % des patients qui présentent une cardiopathie congénitale (CC) atteignent l’âge adulte, et l’intérêt se porte maintenant davantage sur la morbidité à long terme que sur la mortalité précoce. Or, les maladies chroniques sont associées à un risque plus élevé de problèmes cardiaques et psychologiques qui peuvent influer sur la fonction autonome. Nous comparons dans cette étude la variabilité de la fréquence cardiaque (VFC) chez des adultes atteints de CC à celle de sujets témoins. Entre septembre 2023 et février 2024, 124 adultes atteints de CC (33,7 ans ± 10,5 ans, 47,6 % de femmes) et 43 sujets témoins (34,3 ans ± 12 ans, 44,2 % de femmes) ont participé à une évaluation physiologique au moyen de la technologie portable. La VFC a été enregistrée en continu à l’aide de l’appareil vivosmart® 5 de Garmin pendant 7 jours. Une interface de programmation d’applications (API) en santé permettait de synchroniser les données. On a calculé la moyenne quadratique des écarts successifs entre les battements cardiaques (rMSSD) de jour et de nuit en fonction des cycles individuels de sommeil et d’éveil. Les patients atteints de CC affichaient une rMSSD globale inférieure à celle des témoins (CC : 39,9 [33,6; 48,1] vs témoins : 47,0 [39,9; 53,3]; p = 0,001), un résultat attribuable à une rMSSD nocturne basse (CC : 43,5 [34,5; 55,3] vs témoins : 53,1 [47,2; 65,4]; p < 0,001); les différences diurnes n’étaient pas significatives (CC : 35,9 [31,8; 41,6] vs témoins : 39,0 [32,3; 45,1]; p = 0,212). Chez les patients atteints de CC, la VFC était de 17,4 % plus élevée la nuit que le jour, alors que chez les témoins, la VFC était de 46,4 % plus élevée la nuit que le jour, signe d’une récupération de la fonction autonome significativement meilleure chez les témoins pendant la nuit (p < 0,001). Une corrélation positive entre la consommation maximale d’oxygène (VO2 max) et la rMSSD diurne (p < 0,001) et la rMSSD globale (p = 0,017) a été observée chez les patients. Les patients atteints de CC semblent avoir une VFC globale moindre, qui s’explique par une VFC nocturne basse comparativement à celle des témoins. La VFC nocturne est un paramètre essentiel pour la compréhension de la récupération, de la qualité du sommeil et de la santé. Une surveillance continue par des API en santé pourrait permettre une évaluation fiable au long cours de l’état de santé et servir de base à des stratégies personnalisées de prise en charge.
Author Uphoff, Isabel
Ewert, Peter
Müller, Jan
Schöneburg, Charlotte
Oberhoffer-Fritz, Renate
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  surname: Müller
  fullname: Müller, Jan
  organization: Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technische Universität München, München, Germany
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Cites_doi 10.1016/j.jacc.2018.08.1028
10.1016/0002-9149(89)90436-0
10.1164/arrd.1984.129.2P2.S47
10.1161/01.CIR.91.7.1918
10.1513/AnnalsATS.201611-876FR
10.1016/0002-9149(90)90503-S
10.3389/fpubh.2017.00258
10.1093/ejcts/ezab235
10.1136/heartjnl-2016-310828
10.1161/01.CIR.90.1.121
10.1093/eurheartj/eht257
10.1161/CIRCULATIONAHA.111.058719
10.1016/j.ijcard.2009.09.543
10.1038/s41390-024-03432-9
10.1097/HCR.0000000000000511
10.1159/000515835
10.1016/S0167-5273(01)00414-4
10.3389/fpsyg.2014.01040
10.1093/sleepadvances/zpac026
10.1007/s10484-020-09466-z
10.1123/jmpb.2019-0035
10.1016/0002-9149(87)90795-8
10.2196/29434
10.1016/j.crbiot.2023.100164
10.1055/s-0039-1701001
10.1016/j.cjcpc.2024.11.005
10.2196/18694
10.1007/s10286-019-00616-w
10.1007/s004310050979
10.1371/journal.pone.0299793
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Keywords congenital heart disease
telemedicine
heart rate variability
health application programming interface
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References Georgiou, Larentzakis, Khamis (bib13) 2018; 60
Mulkey, Govindan, Metzler (bib31) 2020; 30
Alstrup, Karunanithi, Maagaard, Poulsen, Hjortdal (bib20) 2021; 61
Huikuri, Niemelä, Ojala (bib24) 1994; 90
Tygesen, Wettervik, Wennerblom (bib33) 2001; 79
Manta, Mahadevan, Bakker (bib14) 2021; 5
Evenson, Spade (bib11) 2020; 3
Shaffer, McCraty, Zerr (bib6) 2014; 5
Mantegazza, Apostolo, Hager (bib15) 2017; 14
Fuller, Colwell, Low (bib12) 2020; 8
El-Malahi, Mohajeri, Mincu (bib27) 2024; 19
Stout, Daniels, Aboulhosn (bib9) 2019; 73
Vanoli, Adamson, Pinna, Lazzara, Orr (bib23) 1995; 91
Dullabh, Hovey, Heaney-Huls (bib34) 2020; 11
Cooper, Weiler-Ravell (bib16) 1984; 129
Kleiger, Miller, Bigger, Moss (bib4) 1987; 59
Toyofuku, Ehrler, Naef (bib3) 2025; 97
Lehrer, Kaur, Sharma (bib26) 2020; 45
Gläser, Ittermann, Schäper (bib17) 2012; 67
Tutarel, Kempny, Alonso-Gonzalez (bib1) 2014; 35
Thayer, Yamamoto, Brosschot (bib2) 2010; 141
Fritz, Hock, Oberhoffer (bib18) 2021; 41
Tukey (bib8) 1977
Naseri Jahfari, Tax, Reinders, van der Bilt (bib29) 2022; 10
Shaffer, Ginsberg (bib5) 2017; 5
Massin, von Bernuth (bib22) 1998; 157
Nederend, Jongbloed, de Geus (bib30) 2016; 3
Malik, Farrell, Camm (bib25) 1990; 66
Lau, Ong, Ng (bib10) 2022; 3
Inuzuka, Diller, Borgia (bib32) 2012; 125
Schöneburg, Willinger, Uphoff (bib7) 2025; 4
Bigger, Albrecht, Steinman (bib21) 1989; 64
Chakraborty, Bhattacharya, Pal, Lee (bib28) 2024; 7
Müller, Amberger, Berg (bib19) 2017; 103
Evenson (10.1016/j.cjcpc.2025.07.004_bib11) 2020; 3
Mulkey (10.1016/j.cjcpc.2025.07.004_bib31) 2020; 30
Müller (10.1016/j.cjcpc.2025.07.004_bib19) 2017; 103
Tygesen (10.1016/j.cjcpc.2025.07.004_bib33) 2001; 79
Inuzuka (10.1016/j.cjcpc.2025.07.004_bib32) 2012; 125
Tutarel (10.1016/j.cjcpc.2025.07.004_bib1) 2014; 35
Mantegazza (10.1016/j.cjcpc.2025.07.004_bib15) 2017; 14
Naseri Jahfari (10.1016/j.cjcpc.2025.07.004_bib29) 2022; 10
Thayer (10.1016/j.cjcpc.2025.07.004_bib2) 2010; 141
Fritz (10.1016/j.cjcpc.2025.07.004_bib18) 2021; 41
Tukey (10.1016/j.cjcpc.2025.07.004_bib8) 1977
Stout (10.1016/j.cjcpc.2025.07.004_bib9) 2019; 73
Vanoli (10.1016/j.cjcpc.2025.07.004_bib23) 1995; 91
Manta (10.1016/j.cjcpc.2025.07.004_bib14) 2021; 5
Huikuri (10.1016/j.cjcpc.2025.07.004_bib24) 1994; 90
Lehrer (10.1016/j.cjcpc.2025.07.004_bib26) 2020; 45
El-Malahi (10.1016/j.cjcpc.2025.07.004_bib27) 2024; 19
Chakraborty (10.1016/j.cjcpc.2025.07.004_bib28) 2024; 7
Kleiger (10.1016/j.cjcpc.2025.07.004_bib4) 1987; 59
Georgiou (10.1016/j.cjcpc.2025.07.004_bib13) 2018; 60
Shaffer (10.1016/j.cjcpc.2025.07.004_bib6) 2014; 5
Nederend (10.1016/j.cjcpc.2025.07.004_bib30) 2016; 3
Lau (10.1016/j.cjcpc.2025.07.004_bib10) 2022; 3
Bigger (10.1016/j.cjcpc.2025.07.004_bib21) 1989; 64
Massin (10.1016/j.cjcpc.2025.07.004_bib22) 1998; 157
Malik (10.1016/j.cjcpc.2025.07.004_bib25) 1990; 66
Shaffer (10.1016/j.cjcpc.2025.07.004_bib5) 2017; 5
Alstrup (10.1016/j.cjcpc.2025.07.004_bib20) 2021; 61
Fuller (10.1016/j.cjcpc.2025.07.004_bib12) 2020; 8
Dullabh (10.1016/j.cjcpc.2025.07.004_bib34) 2020; 11
Toyofuku (10.1016/j.cjcpc.2025.07.004_bib3) 2025; 97
Gläser (10.1016/j.cjcpc.2025.07.004_bib17) 2012; 67
Schöneburg (10.1016/j.cjcpc.2025.07.004_bib7) 2025; 4
Cooper (10.1016/j.cjcpc.2025.07.004_bib16) 1984; 129
References_xml – volume: 97
  start-page: 1103
  year: 2025
  end-page: 1113
  ident: bib3
  article-title: Heart rate variability and cognitive functions in adolescents with complex congenital heart disease
  publication-title: Pediatr Res
– volume: 125
  start-page: 250
  year: 2012
  end-page: 259
  ident: bib32
  article-title: Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term
  publication-title: Circulation
– volume: 10
  year: 2022
  ident: bib29
  article-title: Machine learning for cardiovascular outcomes from wearable data: systematic review from a technology readiness level point of view
  publication-title: JMIR Med Inform
– volume: 59
  start-page: 256
  year: 1987
  end-page: 262
  ident: bib4
  article-title: Decreased heart rate variability and its association with increased mortality after acute myocardial infarction
  publication-title: Am J Cardiol
– volume: 11
  start-page: 59
  year: 2020
  end-page: 69
  ident: bib34
  article-title: Application programming interfaces in health care: findings from a current-state sociotechnical assessment
  publication-title: Appl Clin Inform
– volume: 5
  start-page: 1040
  year: 2014
  ident: bib6
  article-title: A healthy heart is not a metronome: an integrative review of the heart's anatomy and heart rate variability
  publication-title: Front Psychol
– volume: 8
  year: 2020
  ident: bib12
  article-title: Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: systematic review
  publication-title: JMIR Mhealth Uhealth
– volume: 5
  start-page: 258
  year: 2017
  ident: bib5
  article-title: An overview of heart rate variability metrics and norms
  publication-title: Front Public Health
– volume: 141
  start-page: 122
  year: 2010
  end-page: 131
  ident: bib2
  article-title: The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors
  publication-title: Int J Cardiol
– volume: 19
  year: 2024
  ident: bib27
  article-title: Beneficial impacts of physical activity on heart rate variability: a systematic review and meta-analysis
  publication-title: PLoS One
– volume: 73
  start-page: 1494
  year: 2019
  end-page: 1563
  ident: bib9
  article-title: 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
  publication-title: J Am Coll Cardiol
– volume: 3
  year: 2022
  ident: bib10
  article-title: Minimum number of nights for reliable estimation of habitual sleep using a consumer sleep tracker
  publication-title: SLEEP Adv
– volume: 7
  year: 2024
  ident: bib28
  article-title: From machine learning to deep learning: advances of the recent data-driven paradigm shift in medicine and healthcare
  publication-title: Curr Res Biotechnol
– volume: 14
  start-page: S93
  year: 2017
  end-page: S101
  ident: bib15
  article-title: Cardiopulmonary exercise testing in adult congenital heart disease
  publication-title: Ann Am Thorac Soc
– volume: 91
  start-page: 1918
  year: 1995
  end-page: 1922
  ident: bib23
  article-title: Heart rate variability during specific sleep stages
  publication-title: Circulation
– year: 1977
  ident: bib8
  article-title: Exploratory data analysis
– volume: 5
  start-page: 127
  year: 2021
  end-page: 147
  ident: bib14
  article-title: EVIDENCE publication checklist for studies evaluating connected sensor technologies: explanation and elaboration
  publication-title: Digit Biomark
– volume: 129
  start-page: S47
  year: 1984
  end-page: S48
  ident: bib16
  article-title: Gas exchange response to exercise in children
  publication-title: Am Rev Respir Dis
– volume: 66
  start-page: 1049
  year: 1990
  end-page: 1054
  ident: bib25
  article-title: Circadian rhythm of heart rate variability after acute myocardial infarction and its influence on the prognostic value of heart rate variability
  publication-title: Am J Cardiol
– volume: 4
  start-page: 69
  year: 2025
  end-page: 80
  ident: bib7
  article-title: Interactive Telehealth solutions for patients with congenital heart disease: a systematic review
  publication-title: CJC Pediatr Congenit Heart Dis
– volume: 3
  start-page: 16
  year: 2016
  ident: bib30
  article-title: Postnatal cardiac autonomic nervous control in pediatric congenital heart disease
  publication-title: J Cardiovasc Dev Dis
– volume: 103
  start-page: 1117
  year: 2017
  end-page: 1121
  ident: bib19
  article-title: Physical activity in adults with congenital heart disease and associations with functional outcomes
  publication-title: Heart
– volume: 45
  start-page: 109
  year: 2020
  end-page: 129
  ident: bib26
  article-title: Heart rate variability biofeedback improves emotional and physical health and performance: a systematic review and meta analysis
  publication-title: Appl Psychophysiol Biofeedback
– volume: 157
  start-page: 967
  year: 1998
  end-page: 971
  ident: bib22
  article-title: Clinical and haemodynamic correlates of heart rate variability in children with congenital heart disease
  publication-title: Eur J Pediatr
– volume: 30
  start-page: 165
  year: 2020
  end-page: 172
  ident: bib31
  article-title: Heart rate variability is depressed in the early transitional period for newborns with complex congenital heart disease
  publication-title: Clin Auton Res
– volume: 67
  start-page: 58
  year: 2012
  end-page: 63
  ident: bib17
  article-title: [The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing]
  publication-title: Pneumologie
– volume: 3
  start-page: 170
  year: 2020
  end-page: 185
  ident: bib11
  article-title: Review of validity and reliability of Garmin activity trackers
  publication-title: J Meas Phys Behav
– volume: 61
  start-page: 83
  year: 2021
  end-page: 89
  ident: bib20
  article-title: Sympathovagal imbalance decades after atrial septal defect repair: a long-term follow-up study
  publication-title: Eur J Cardiothoracic Surg
– volume: 64
  start-page: 536
  year: 1989
  end-page: 538
  ident: bib21
  article-title: Comparison of time- and frequency domain-based measures of cardiac parasympathetic activity in Holter recordings after myocardial infarction
  publication-title: Am J Cardiol
– volume: 35
  start-page: 725
  year: 2014
  end-page: 732
  ident: bib1
  article-title: Congenital heart disease beyond the age of 60: emergence of a new population with high resource utilization, high morbidity, and high mortality
  publication-title: Eur Heart J
– volume: 60
  start-page: 7
  year: 2018
  end-page: 20
  ident: bib13
  article-title: Can wearable devices accurately measure heart rate variability? A systematic review
  publication-title: Folia Med (Plovdiv)
– volume: 90
  start-page: 121
  year: 1994
  end-page: 126
  ident: bib24
  article-title: Circadian rhythms of frequency domain measures of heart rate variability in healthy subjects and patients with coronary artery disease. Effects of arousal and upright posture
  publication-title: Circulation
– volume: 41
  start-page: 35
  year: 2021
  end-page: 39
  ident: bib18
  article-title: Reduced parasympathetic activity in patients with different types of congenital heart disease and associations to exercise capacity
  publication-title: J Cardiopulm Rehabil Prev
– volume: 79
  start-page: 175
  year: 2001
  end-page: 182
  ident: bib33
  article-title: Intensive home-based exercise training in cardiac rehabilitation increases exercise capacity and heart rate variability
  publication-title: Int J Cardiol
– volume: 73
  start-page: 1494
  year: 2019
  ident: 10.1016/j.cjcpc.2025.07.004_bib9
  article-title: 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
  publication-title: J Am Coll Cardiol
  doi: 10.1016/j.jacc.2018.08.1028
– volume: 64
  start-page: 536
  year: 1989
  ident: 10.1016/j.cjcpc.2025.07.004_bib21
  article-title: Comparison of time- and frequency domain-based measures of cardiac parasympathetic activity in Holter recordings after myocardial infarction
  publication-title: Am J Cardiol
  doi: 10.1016/0002-9149(89)90436-0
– volume: 129
  start-page: S47
  issue: Pt 2
  year: 1984
  ident: 10.1016/j.cjcpc.2025.07.004_bib16
  article-title: Gas exchange response to exercise in children
  publication-title: Am Rev Respir Dis
  doi: 10.1164/arrd.1984.129.2P2.S47
– volume: 91
  start-page: 1918
  year: 1995
  ident: 10.1016/j.cjcpc.2025.07.004_bib23
  article-title: Heart rate variability during specific sleep stages
  publication-title: Circulation
  doi: 10.1161/01.CIR.91.7.1918
– year: 1977
  ident: 10.1016/j.cjcpc.2025.07.004_bib8
– volume: 14
  start-page: S93
  issue: suppl 1
  year: 2017
  ident: 10.1016/j.cjcpc.2025.07.004_bib15
  article-title: Cardiopulmonary exercise testing in adult congenital heart disease
  publication-title: Ann Am Thorac Soc
  doi: 10.1513/AnnalsATS.201611-876FR
– volume: 66
  start-page: 1049
  year: 1990
  ident: 10.1016/j.cjcpc.2025.07.004_bib25
  article-title: Circadian rhythm of heart rate variability after acute myocardial infarction and its influence on the prognostic value of heart rate variability
  publication-title: Am J Cardiol
  doi: 10.1016/0002-9149(90)90503-S
– volume: 5
  start-page: 258
  year: 2017
  ident: 10.1016/j.cjcpc.2025.07.004_bib5
  article-title: An overview of heart rate variability metrics and norms
  publication-title: Front Public Health
  doi: 10.3389/fpubh.2017.00258
– volume: 61
  start-page: 83
  year: 2021
  ident: 10.1016/j.cjcpc.2025.07.004_bib20
  article-title: Sympathovagal imbalance decades after atrial septal defect repair: a long-term follow-up study
  publication-title: Eur J Cardiothoracic Surg
  doi: 10.1093/ejcts/ezab235
– volume: 103
  start-page: 1117
  year: 2017
  ident: 10.1016/j.cjcpc.2025.07.004_bib19
  article-title: Physical activity in adults with congenital heart disease and associations with functional outcomes
  publication-title: Heart
  doi: 10.1136/heartjnl-2016-310828
– volume: 90
  start-page: 121
  year: 1994
  ident: 10.1016/j.cjcpc.2025.07.004_bib24
  article-title: Circadian rhythms of frequency domain measures of heart rate variability in healthy subjects and patients with coronary artery disease. Effects of arousal and upright posture
  publication-title: Circulation
  doi: 10.1161/01.CIR.90.1.121
– volume: 35
  start-page: 725
  year: 2014
  ident: 10.1016/j.cjcpc.2025.07.004_bib1
  article-title: Congenital heart disease beyond the age of 60: emergence of a new population with high resource utilization, high morbidity, and high mortality
  publication-title: Eur Heart J
  doi: 10.1093/eurheartj/eht257
– volume: 125
  start-page: 250
  year: 2012
  ident: 10.1016/j.cjcpc.2025.07.004_bib32
  article-title: Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term
  publication-title: Circulation
  doi: 10.1161/CIRCULATIONAHA.111.058719
– volume: 141
  start-page: 122
  year: 2010
  ident: 10.1016/j.cjcpc.2025.07.004_bib2
  article-title: The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors
  publication-title: Int J Cardiol
  doi: 10.1016/j.ijcard.2009.09.543
– volume: 97
  start-page: 1103
  year: 2025
  ident: 10.1016/j.cjcpc.2025.07.004_bib3
  article-title: Heart rate variability and cognitive functions in adolescents with complex congenital heart disease
  publication-title: Pediatr Res
  doi: 10.1038/s41390-024-03432-9
– volume: 41
  start-page: 35
  year: 2021
  ident: 10.1016/j.cjcpc.2025.07.004_bib18
  article-title: Reduced parasympathetic activity in patients with different types of congenital heart disease and associations to exercise capacity
  publication-title: J Cardiopulm Rehabil Prev
  doi: 10.1097/HCR.0000000000000511
– volume: 67
  start-page: 58
  year: 2012
  ident: 10.1016/j.cjcpc.2025.07.004_bib17
  article-title: [The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing]
  publication-title: Pneumologie
– volume: 5
  start-page: 127
  year: 2021
  ident: 10.1016/j.cjcpc.2025.07.004_bib14
  article-title: EVIDENCE publication checklist for studies evaluating connected sensor technologies: explanation and elaboration
  publication-title: Digit Biomark
  doi: 10.1159/000515835
– volume: 79
  start-page: 175
  year: 2001
  ident: 10.1016/j.cjcpc.2025.07.004_bib33
  article-title: Intensive home-based exercise training in cardiac rehabilitation increases exercise capacity and heart rate variability
  publication-title: Int J Cardiol
  doi: 10.1016/S0167-5273(01)00414-4
– volume: 5
  start-page: 1040
  year: 2014
  ident: 10.1016/j.cjcpc.2025.07.004_bib6
  article-title: A healthy heart is not a metronome: an integrative review of the heart's anatomy and heart rate variability
  publication-title: Front Psychol
  doi: 10.3389/fpsyg.2014.01040
– volume: 3
  year: 2022
  ident: 10.1016/j.cjcpc.2025.07.004_bib10
  article-title: Minimum number of nights for reliable estimation of habitual sleep using a consumer sleep tracker
  publication-title: SLEEP Adv
  doi: 10.1093/sleepadvances/zpac026
– volume: 45
  start-page: 109
  year: 2020
  ident: 10.1016/j.cjcpc.2025.07.004_bib26
  article-title: Heart rate variability biofeedback improves emotional and physical health and performance: a systematic review and meta analysis
  publication-title: Appl Psychophysiol Biofeedback
  doi: 10.1007/s10484-020-09466-z
– volume: 3
  start-page: 170
  year: 2020
  ident: 10.1016/j.cjcpc.2025.07.004_bib11
  article-title: Review of validity and reliability of Garmin activity trackers
  publication-title: J Meas Phys Behav
  doi: 10.1123/jmpb.2019-0035
– volume: 59
  start-page: 256
  year: 1987
  ident: 10.1016/j.cjcpc.2025.07.004_bib4
  article-title: Decreased heart rate variability and its association with increased mortality after acute myocardial infarction
  publication-title: Am J Cardiol
  doi: 10.1016/0002-9149(87)90795-8
– volume: 10
  year: 2022
  ident: 10.1016/j.cjcpc.2025.07.004_bib29
  article-title: Machine learning for cardiovascular outcomes from wearable data: systematic review from a technology readiness level point of view
  publication-title: JMIR Med Inform
  doi: 10.2196/29434
– volume: 7
  year: 2024
  ident: 10.1016/j.cjcpc.2025.07.004_bib28
  article-title: From machine learning to deep learning: advances of the recent data-driven paradigm shift in medicine and healthcare
  publication-title: Curr Res Biotechnol
  doi: 10.1016/j.crbiot.2023.100164
– volume: 11
  start-page: 59
  year: 2020
  ident: 10.1016/j.cjcpc.2025.07.004_bib34
  article-title: Application programming interfaces in health care: findings from a current-state sociotechnical assessment
  publication-title: Appl Clin Inform
  doi: 10.1055/s-0039-1701001
– volume: 3
  start-page: 16
  year: 2016
  ident: 10.1016/j.cjcpc.2025.07.004_bib30
  article-title: Postnatal cardiac autonomic nervous control in pediatric congenital heart disease
  publication-title: J Cardiovasc Dev Dis
– volume: 4
  start-page: 69
  year: 2025
  ident: 10.1016/j.cjcpc.2025.07.004_bib7
  article-title: Interactive Telehealth solutions for patients with congenital heart disease: a systematic review
  publication-title: CJC Pediatr Congenit Heart Dis
  doi: 10.1016/j.cjcpc.2024.11.005
– volume: 8
  year: 2020
  ident: 10.1016/j.cjcpc.2025.07.004_bib12
  article-title: Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: systematic review
  publication-title: JMIR Mhealth Uhealth
  doi: 10.2196/18694
– volume: 60
  start-page: 7
  year: 2018
  ident: 10.1016/j.cjcpc.2025.07.004_bib13
  article-title: Can wearable devices accurately measure heart rate variability? A systematic review
  publication-title: Folia Med (Plovdiv)
– volume: 30
  start-page: 165
  year: 2020
  ident: 10.1016/j.cjcpc.2025.07.004_bib31
  article-title: Heart rate variability is depressed in the early transitional period for newborns with complex congenital heart disease
  publication-title: Clin Auton Res
  doi: 10.1007/s10286-019-00616-w
– volume: 157
  start-page: 967
  year: 1998
  ident: 10.1016/j.cjcpc.2025.07.004_bib22
  article-title: Clinical and haemodynamic correlates of heart rate variability in children with congenital heart disease
  publication-title: Eur J Pediatr
  doi: 10.1007/s004310050979
– volume: 19
  year: 2024
  ident: 10.1016/j.cjcpc.2025.07.004_bib27
  article-title: Beneficial impacts of physical activity on heart rate variability: a systematic review and meta-analysis
  publication-title: PLoS One
  doi: 10.1371/journal.pone.0299793
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Snippet With 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health...
AbstractBackgroundWith 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term...
SourceID crossref
elsevier
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Publisher
SubjectTerms Cardiovascular
congenital heart disease
health application programming interface
heart rate variability
telemedicine
Title Heart Rate Variability in Congenital Heart Disease and Controls Using Wearable Technology and a Health Application Programming Interface—A Cross-sectional Study
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