Introduction
In the previous chapter, we presented a systematic method for interpreting FibrCheck PPG recordings to enable you to distinguish between regular and potentially irregular heart rhythms. In this chapter, we aim to offer a more comprehensive understanding of the various patterns and the associated arrhythmias, complete with illustrative FibriCheck PPG examples.
Green (normal) recordings resemble regular traces
These recordings are labeled as ‘normal’, indicating that a low variability in the heart rhythm was detected during the measurement. Below, you can find an overview of the different labels from measurements with a regular indicator.
| Label | Description | Example recording |
|
Regular Rhythm |
✔️ Regular waveforms with consistent distances from each other ✔️ Tachogram shows a relatively straight line ✔️ Poincaré plot shows a dense, centered cluster |
|
| Increased Heart Rate Variability |
✔️ Regular waveforms with relatively consistent distances from each other ✔️ Tachogram shows a wave pattern, oscillating around the trend line ✔️ Poincaré plot shows a relatively dense, elipse-shaped cluster |
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|
Isolated extrasystoles (max. 5) |
✔️ Regular waveforms with isolated, premature waveforms (<6 in a 60-second trace), followed by a compensatory break ✔️ Tachogram shows a relatively straight line, with isolated outliers ✔️ Poincaré plot shows a dense, centered cluster with isolated outliers |
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Orange (warning) recordings resemble possible non-atrial fibrillation traces
These recordings are labeled as ‘warning’, indicating that rhythm variability is detected which might indicate a possible finding of a non-AF arrhythmia such as frequent ectopic beats, a tachycardia episode, a bigeminy episode, etc. Below, you can find an overview of the different labels from measurements with a warning indicator.
| Label | Description | Example recording |
|
Frequent extrasystoles (min. 6) |
✔️ Regular waveforms with frequent, premature waveforms, followed by a compensatory break ✔️ Tachogram shows a relatively straight line, with frequent outliers ✔️ Poincaré plot shows a dense, centered cluster with frequent outliers (island formation) |
|
| Bigeminy |
✔️ Each waveform is followed by a premature waveform ✔️ Tachogram shows two relatively straight lines throughout the entire trace ✔️ Poincaré plot shows two dense clusters |
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|
Bigeminy episode (min. 3 cycles) |
✔️ At least 3 consecutive cycles in which a waveform is followed by a premature waveform ✔️ Tachogram shows two relatively straight lines throughout part of the trace ✔️ Poincaré plot shows two dense clusters |
|
| Trigeminy |
✔️ Each second waveform is followed by a premature waveform ✔️ Tachogram shows three relatively straight lines throughout the entire trace ✔️ Poincaré plot shows three dense clusters |
|
| Trigeminy episode |
✔️ At least three consecutive cycles in which two waveforms are followed by a premature waveform ✔️ Tachogram shows three relatively straight lines throughout part of the trace ✔️ Poincaré plot shows three dense, centered clusters |
|
| Tachycardia |
✔️ Regular waveforms with consistent distances from each other, with a heart rate above 110 beats per minute ✔️ Tachogram shows a relatively straight line ✔️ Poincaré plot shows a dense, centered cluster on the lower, left side of the plot |
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| Tachycardia episode |
✔️ Regular waveforms with consistent distances from each other ✔️ Tachogram shows a relatively straight line, with a sudden drop on the tachogram ✔️ Poincaré plot shows a dense, centered cluster, smeared towards the lower, left side of the plot |
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| Bradycardia |
✔️ Regular waveforms with consistent distances from each other, with a heart rate below 40 beats per minute ✔️ Tachogram shows a relatively straight line ✔️ Poincaré plot shows a dense, centered cluster on the upper, right side of the plot |
|
| Bradycardia episode |
✔️ Regular waveforms with consistent distances from each other ✔️ Tachogram shows a relatively straight line, with a sudden increase on the tachogram ✔️ Poincaré plot shows a dense, centered cluster, smeared towards the upper, right side of the plot |
Red (urgent) recordings resemble possible atrial fibrillation traces
These recordings are labeled as ‘urgent’, indicating that rhythm variability is detected which might indicate possible atrial fibrillation or atrial flutter. In case of urgent recordings, FibriCheck instructs individuals to consult their physician for further examination. Below, you can find an overview of the different labels of measurements with an urgent indicator.
| Label | Description | Example recording |
| Atrial fibrillation |
✔️ Irregular waveforms with inconsistent distances from each other ✔️ Tachogram shows a random, chaotic pattern ✔️ Poincaré plot shows a chaotic, spread cluster |
|
| Atrial flutter |
✔️ Atrial flutter is characterised by different patterns of waveforms ✔️ Regular rhythm pattern or more irregular pattern due to the variable atrioventricular conduction (2:1, 3:1, 4:1 block) |
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