IJCS | Volume 32, Nº4, July/August 2019

DOI: 10.5935/2359-4802.20190061 396 REVIEW ARTICLE International Journal of Cardiovascular Sciences. 2019;32(4):396-407 Mailing Address: Marcos Almeida Universidade Federal de Sergipe - Avenida Marechal Rondon – Sn. Postal Code: 49100-000, São Cristóvão, SE – Brazil. E-mail: mb.almeida@ufs.br Measuring Heart Rate During Exercise: From Artery Palpation to Monitors and Apps Marcos Almeida, 1 Altamiro Bottino, 2 P línio Ramos, 3 C laudio Gil Araujo 4 Universidade Federal de Sergipe, 1 São Cristóvão, SE - Brazil Coordenação Científica do São Paulo Futebol Clube, 2 São Paulo, SP - Brazil Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, 3 Juiz de Fora, MG - Brazil Exercise Medicine Clinic – CLINIMEX, 4 Rio de Janeiro, RJ - Brazil Manuscript received May 06, 2019, revised manuscript May 23, 2019, accepted May 27, 2019. Exercise; Heart Rate, Palpation; Exercise Therapy; Fitness Trackers; Monitoring, Physiologic. Keywords Abstract The use of technology has increased tremendously, by means of more reliable, smaller, more accessible and specially more user-friendly devices, which provide a wider range of features, and promote significant benefits for the population and health professionals. It is in this context that monitors and apps for heart rate (HR) measurement have emerged. HR is a clinical vital sign of diagnostic and prognostic importance. In response to body movement, HR tends to increase, in a direct relationship with the intensity of exercise. HR was primarily measured by the count of arterial pulse, and recently, HR can be precisely measured by monitors, bracelets and smartphone apps capable to perform real-time measurements and storage of data. This paper aimed to make a brief and updated review on the theme, providing a broader view of advantages and limitations of these resources for HRmeasurement in exercise. HR monitors and apps use basically two types of technology, optical sensor (photoplethysmography) and electrical signal from the heart. In general, these devices have shown good accuracy inmeasuring HR and HR variability at rest, but there are differences between brands and models considering the type, mode and intensity of exercise. HRmeasurements by monitors and smartphone apps are simple, accessible and may help cardiologists in the monitoring of the intensity of aerobic exercise, focusing on health promotion and on primary and secondary prevention of cardiovascular diseases. Introduction The use of technology in health has exponentially increased, fostering the use of monitors andmobile apps for heart rate (HR) measurement. Recent equipment and resources for HR monitoring are better, more accurate, more compact, cheaper and more user-friendly, and provide a wider range of features and greater recording and storage capacity. Therefore, be it in-person or via telemedicine, these technologies have the potential to generate benefits to the population and to facilitate and be a complement to medical services. 1 HR is the most important vital sign; it is one of the most remote indicator of health since early civilizations. 2 The assessment of HR can be clinically used in case of suspected pulmonary embolismand acute infections. 3 HR is expressed as beats per minute (bpm), and is modulated by autonomic nervous system. 4 From a clinical and epidemiological point of view, life expectancy seems to be inversely correlated with HR at rest and positively correlated with maximum heart rate during exercise, magnitude of HR decrease after exercise, and the combination of these three variables, as assessed by HR gradient during exercise, proposed by Brazilian authors. 5 In response to body movement, HR tends to rise, causing an increase in cardiac output, and transport of oxygen and substrates to the tissues, and removal of CO 2 andwastes from them. 2 Inmaximal incremental exercise, HR tends to gradually increase until its maximum Prof. Dr. Marcos Bezerra de Almeida Departamento de Educação Física Programa de Pós-Graduação em Educação Física Universidade Federal de Sergipe mb.almeida@gmail.com