Video-based heart rate monitoring across a range of skin pigmentations during an acute hypoxic challenge

The robust monitoring of heart rate from the video-photoplethysmogram (video-PPG) during challenging conditions requires new analysis techniques. The work reported here extends current research in this area by applying a motion tolerant algorithm to extract high quality video-PPGs from a cohort of subjects undergoing marked heart rate changes during a hypoxic challenge, and exhibiting a full range of skin pigmentation types. High uptimes in reported video-based heart rate (HR(vid)) were targeted, while retaining high accuracy in the results. Ten healthy volunteers were studied during a double desaturation hypoxic challenge. Video-PPGs were generated from the acquired video image stream and processed to generate heart rate. HR(vid) was compared to the pulse rate posted by a reference pulse oximeter device (HR(p)). Agreement between video-based heart rate and that provided by the pulse oximeter was as follows: Bias = − 0.21 bpm, RMSD = 2.15 bpm, least squares fit gradient = 1.00 (Pearson R = 0.99, p < 0.0001), with a 98.78% reporting uptime. The difference between the HR(vid) and HR(p) exceeded 5 and 10 bpm, for 3.59 and 0.35% of the reporting time respectively, and at no point did these differences exceed 25 bpm. Excellent agreement was found between the HR(vid) and HR(p) in a study covering the whole range of skin pigmentation types (Fitzpatrick scales I–VI), using standard room lighting and with moderate subject motion. Although promising, further work should include a larger cohort with multiple subjects per Fitzpatrick class combined with a more rigorous motion and lighting protocol.