Proceedings of the 17th Iranian Conference of Biomedical E ngineering (ICBME 2010), 3-4 November 2010
978-1-4244-7484-4/10/$26.00 ©2010 IEEE
Figure 1. Poincare plot of RR intervals of a healthy person with its
standard descriptors SD1 and SD2
Utilizing Occurrence Sequence of Heart Rate’s Phase
Space Points in order to Discriminate Heart
Arrhythmia
S Moharreri, S Parvaneh, N Jafarnia Dabanloo
Islamic Azad University, Science and Research Branch
Tehran, Iran
sadaf.moharreri@gmail.com; parvaneh@ieee.org
n_jafarnia@yahoo.com
A M Nasrabadi
Shahed University
Tehran, Iran
Abstract— Poincare plot analysis of RR time series allows a beat-
to-beat approach to Heart Rate Variability (HRV), detecting
patterns associated with nonlinear processes. Since the
measurement of standards descriptors of Poincare plot is based
on the point's distribution in relation to the line of identity (y=x),
we have concentrated on it and evaluated the points behavior
related to this line. For this purpose, we test two global and local
analyses of points against the identity line. For evaluating these
two novel features of Poincare plot, we try to use them for
distinguishing four groups of subjects (Arrhythmia, Congestive
Heart Failure (CHF), Atrial Fibrillation (AF) and Normal Sinus
Rhythm (NSR)). Kruskal-Wallis test was used to define the level
of significance of features. The results show that global feature
discriminate different groups by p<6E-7, and local feature
discriminate them by p<2E-7.
Keywords- poincare plot; heart rate variability; temporal
variations; occurrence
I. INTRODUCTION
Heart rate is an indicator of heart's condition [1].
Assessment of heart rate has been shown to aid clinical
diagnosis and intervention strategies. It has been proved that
nonlinear analysis of it might provide more valuable
information for the physiological interpretation of heart rate
fluctuations [2]. However, the variety of contradictory reports
in this field indicates that there is a need for a more rigorous
investigation of methods as aids to clinical evaluation [2]. The
nonlinear analysis of Heart Rate Variability (HRV) is a
valuable tool in both clinical practice and physiological
research reflecting the ability of the cardiovascular system.
The Poincare plot is a tool developed by Henry Poincare for
analyzing complex systems [1]. It has found its use in such
diverse fields as physics and astronomy, geophysics,
meteorology, mathematical biology and medical sciences. In
the context of medical sciences it is mainly used for
quantifying HRV and proves to be quite an effective measure
of this marker [3]. Poincare plot is a geometrical representation
of RR time series to demonstrate patterns of heart rate
dynamics resulting from nonlinear processes. Poincare plot
analysis of RR time series allows a beat-to-beat approach to
HRV, detecting patterns associated with nonlinear processes. It
is a familiar method for the analysis of two-dimensional
nonlinear dynamic systems[4]. Tulppo et. al. [5] fitted an
ellipse to the distribution of the poincare plot and defined two
standard descriptors SD1 and SD2 for quantification of the
poincare plot geometry. These standard descriptors represent
the minor axis and the major axis of the ellipse (Fig. 1) and
guide the visual inspection of the distribution. In case of HRV,
it reveals a useful visual pattern of the RR interval data by
representing both short and long term variations of the signal
[6]. But standard descriptors SD1 and SD2 are linear statistics
and hence the measures do not directly quantify the nonlinear
temporal variations in the time series contained in the poincare
plot. Moreover, the limitations of the SD1/SD2 analysis are
important to understand when attempting to investigate the
physiological mechanisms in a time series, or when analyzing
data where the occurrence of nonlinear behavior may be a
distinguishing feature between health and disease[6].
The identity line (y = x) in the poincare plot has a simple
physiological interpretation: the points on this line correspond
to equal consecutive RR intervals, the points above it
correspond to increasing heart rate and the points below this
line to decreasing heart rate[7].Since the measurement of
standards descriptors of poincare plot is based on the point's
distribution in relation to the line of identity (y=x), we have
concentrated on it and evaluated the points behavior related to