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Accuracy of the StressEraser (R) in the detection of cardiac rhythms

StressEraser (R) is a commercially marketed biofeedback device designed to enhance heart rate variability. StressEraser (R) makes its internal calculations on beat-to-beat measures of finger pulse intervals. However, the accuracy and precision of StressEraser (R) in quantifying interbeat intervals using finger pulse intervals has not been evaluated against standard laboratory equipment using R-R intervals. Accuracy was assessed by simultaneously recording interbeat intervals using StressEraser (R) and a standard laboratory ECG system. The interbeat intervals were highly correlated between the systems. The average deviation in interbeat interval recordings between the systems was approximately 6 ms. Moreover, correlations approached unity between the systems on estimates of heart period, heart rate, and heart rate variability. Feedback from StressEraser (R) is based on an interbeat time series that provides sufficient information to provide an excellent estimate of the dynamic changes in heart rate and heart rate variability. The slight variations between StressEraser (R) and the laboratory equipment in quantifying heart rate and heart rate variability are due to features related to monitoring heart rate with finger pulse: (1) a lack in precision in the peak of the finger pulse relative to the clearly defined inflection point in the R-wave, and (2) contribution of variations in pulse transit time


Heilman, KJ., Handelman, M., Lewis, G., & Porges, S. (2008). Accuracy of the StressEraser (R) in the detection of cardiac rhythms. Applied Psychophysiology and Biofeedback, 33(2), 83-89. https://doi.org/10.1007/s10484-008-9054-1

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