HRnV-Calc: A software package for heart rate n-variability and heart rate variability analysis

Objective: Heart rate variability (HRV) has been proven to be an important indicator of physiological status for numerous applications. Despite the progress and active developments made in HRV metric research over the last few decades, the representation of the heartbeat sequence upon which HRV is based has received relatively little attention. The recently introduced heart rate n-variability (HRnV) offers an alternative to R-to-R peak interval representations which complements conventional HRV analysis by considering HRV behavior on varying scales. Although HRnV has been shown to improve triage in pilot studies, there is currently no open and standard software to support future research of HRnV and its broader clinical applications. We aimed to develop an open, reliable, and easy to use software package implementing HRnV for further research and improvements of HRnV. This package has been designed to facilitate collaborative investigations between clinicians and researchers to study HRnV in various contexts and applications. Approach: We developed an open-source software, HRnV-Calc, based on the PhysioNet Cardiovascular Signal Toolbox (PCST), which features comprehensive graphical user interfaces (GUIs) for HRnV and HRV analysis. Main results: While preserving the core functionalities and performance of PCST, HRnV-Calc enables step-by-step manual inspection and configuration of HRV and HRnV analysis, so that results can be debugged, easily interpreted, and integrated to downstream applications. Significance: The open-source HRnV-Calc software, an accessible and standardized HRV and HRnV analysis platform, enhances the scope of HRV assessment and is designed to assist in future improvements and applications of HRnV and related research.