Remote photoplethysmography (rPPG) enables non-contact, continuous monitoring of physiological signals and offers a practical alternative to traditional health sensing methods. Although rPPG is promising for daily health monitoring, its application in long-term personal care scenarios, such as mirror-facing routines in high-altitude environments, remains challenging due to ambient lighting variations, frequent occlusions from hand movements, and dynamic facial postures. To address these challenges, we present LADH (Long-term Altitude Daily Health), the first long-term rPPG dataset containing 240 synchronized RGB and infrared (IR) facial videos from 21 participants across five common personal care scenarios, along with ground-truth PPG, respiration, and blood oxygen signals. Our experiments demonstrate that combining RGB and IR video inputs improves the accuracy and robustness of non-contact physiological monitoring, achieving a mean absolute error (MAE) of 4.99 BPM in heart rate estimation. Furthermore, we find that multi-task learning enhances performance across multiple physiological indicators simultaneously. Dataset and code are open at https://github.com/McJackTang/FusionVitals.
Heart failure (HF) poses a significant global health challenge, with early detection offering opportunities for improved outcomes. Abnormalities in heart rate (HR), particularly during daily activities, may serve as early indicators of HF risk. However, existing HR monitoring tools for HF detection are limited by their reliability on population-based averages. The estimation of individualized HR serves as a dynamic digital twin, enabling precise tracking of cardiac health biomarkers. Current HR estimation methods, categorized into physiologically-driven and purely data-driven models, struggle with efficiency and interpretability. This study introduces a novel physiological-model-based neural network (PMB-NN) framework for HR estimation based on oxygen uptake (VO2) data during daily physical activities. The framework was trained and tested on individual datasets from 12 participants engaged in activities including resting, cycling, and running. By embedding physiological constraints, which were derived from our proposed simplified human movement physiological model (PM), into the neural network training process, the PMB-NN model adheres to human physiological principles while achieving high estimation accuracy, with a median R$^2$ score of 0.8 and an RMSE of 8.3 bpm. Comparative statistical analysis demonstrates that the PMB-NN achieves performance on par with the benchmark neural network model while significantly outperforming traditional physiological model (p=0.002). In addition, our PMB-NN is adept at identifying personalized parameters of the PM, enabling the PM to generate reasonable HR estimation. The proposed framework with a precise VO2 estimation system derived from body movements enables the future possibilities of personalized and real-time cardiac monitoring during daily life physical activities.
Auscultation, particularly heart sound, is a non-invasive technique that provides essential vital sign information. Recently, self-supervised acoustic representation foundation models (FMs) have been proposed to offer insights into acoustics-based vital signs. However, there has been little exploration of the extent to which auscultation is encoded in these pre-trained FM representations. In this work, using a publicly available phonocardiogram (PCG) dataset and a heart rate (HR) estimation model, we conduct a layer-wise investigation of six acoustic representation FMs: HuBERT, wav2vec2, wavLM, Whisper, Contrastive Language-Audio Pretraining (CLAP), and an in-house CLAP model. Additionally, we implement the baseline method from Nie et al., 2024 (which relies on acoustic features) and show that overall, representation vectors from pre-trained foundation models (FMs) offer comparable performance to the baseline. Notably, HR estimation using the representations from the audio encoder of the in-house CLAP model outperforms the results obtained from the baseline, achieving a lower mean absolute error (MAE) across various train/validation/test splits despite the domain mismatch.
Fetal health monitoring through one-dimensional Doppler ultrasound (DUS) signals offers a cost-effective and accessible approach that is increasingly gaining interest. Despite its potential, the development of machine learning based techniques to assess the health condition of mothers and fetuses using DUS signals remains limited. This scarcity is primarily due to the lack of extensive DUS datasets with a reliable reference for interpretation and data imbalance across different gestational ages. In response, we introduce a novel autoregressive generative model designed to map fetal electrocardiogram (FECG) signals to corresponding DUS waveforms (Auto-FEDUS). By leveraging a neural temporal network based on dilated causal convolutions that operate directly on the waveform level, the model effectively captures both short and long-range dependencies within the signals, preserving the integrity of generated data. Cross-subject experiments demonstrate that Auto-FEDUS outperforms conventional generative architectures across both time and frequency domain evaluations, producing DUS signals that closely resemble the morphology of their real counterparts. The realism of these synthesized signals was further gauged using a quality assessment model, which classified all as good quality, and a heart rate estimation model, which produced comparable results for generated and real data, with a Bland-Altman limit of 4.5 beats per minute. This advancement offers a promising solution for mitigating limited data availability and enhancing the training of DUS-based fetal models, making them more effective and generalizable.
Camera-based monitoring of vital signs, also known as imaging photoplethysmography (iPPG), has seen applications in driver-monitoring, perfusion assessment in surgical settings, affective computing, and more. iPPG involves sensing the underlying cardiac pulse from video of the skin and estimating vital signs such as the heart rate or a full pulse waveform. Some previous iPPG methods impose model-based sparse priors on the pulse signals and use iterative optimization for pulse wave recovery, while others use end-to-end black-box deep learning methods. In contrast, we introduce methods that combine signal processing and deep learning methods in an inverse problem framework. Our methods estimate the underlying pulse signal and heart rate from facial video by learning deep-network-based denoising operators that leverage deep algorithm unfolding and deep equilibrium models. Experiments show that our methods can denoise an acquired signal from the face and infer the correct underlying pulse rate, achieving state-of-the-art heart rate estimation performance on well-known benchmarks, all with less than one-fifth the number of learnable parameters as the closest competing method.
Heart rate is a physiological signal that provides information about an individual's health and affective state. Remote photoplethysmography (rPPG) allows the estimation of this signal from video recordings of a person's face. Classical rPPG methods make use of signal processing techniques, while recent rPPG methods utilize deep learning networks. Methods are typically evaluated on datasets collected in well-lit environments with participants at resting heart rates. However, little investigation has been done on how well these methods adapt to variations in illumination and heart rate. In this work, we systematically evaluate representative state-of-the-art methods for remote heart rate estimation. Specifically, we evaluate four classical methods and four deep learning-based rPPG estimation methods in terms of their generalization ability to changing scenarios, including low lighting conditions and elevated heart rates. For a thorough evaluation of existing approaches, we collected a novel dataset called CHILL, which systematically varies heart rate and lighting conditions. The dataset consists of recordings from 45 participants in four different scenarios. The video data was collected under two different lighting conditions (high and low) and normal and elevated heart rates. In addition, we selected two public datasets to conduct within- and cross-dataset evaluations of the rPPG methods. Our experimental results indicate that classical methods are not significantly impacted by low-light conditions. Meanwhile, some deep learning methods were found to be more robust to changes in lighting conditions but encountered challenges in estimating high heart rates. The cross-dataset evaluation revealed that the selected deep learning methods underperformed when influencing factors such as elevated heart rates and low lighting conditions were not present in the training set.
Photoplethysmography (PPG) sensors have been widely used in consumer wearable devices to monitor heart rates (HR) and heart rate variability (HRV). Despite the prevalence, PPG signals can be contaminated by motion artifacts induced from daily activities. Existing approaches mainly use the amplitude information to perform PPG peak detection. However, these approaches cannot accurately identify peaks, since motion artifacts may bring random and significant amplitude variations. To improve the performance of PPG peak detection, the time information can be used. Specifically, heart rates exhibit temporal consistency that consecutive heartbeat intervals in a normal person can have limited variations. To leverage the temporal consistency, we propose the Temporal Attentive U-Net, i.e., TAU, to accurately detect peaks from PPG signals. In TAU, we design a time module that encodes temporal consistency in temporal embeddings. We integrate the amplitude information with temporal embeddings using the attention mechanism to estimate peak labels. Our experimental results show that TAU outperforms eleven baselines on heart rate estimation by more than 22.4%. Our TAU model achieves the best performance across various Signal-to-Noise Ratio (SNR) levels. Moreover, we achieve Pearson correlation coefficients higher than 0.9 (p < 0.01) on estimating HRV features from low-noise-level PPG signals.
Heart rate (HR) monitoring is crucial for assessing physical fitness, cardiovascular health, and stress management. Millimeter-wave radar offers a promising noncontact solution for long-term monitoring. However, accurate HR estimation remains challenging in low signal-tonoise ratio (SNR) conditions. To deal with both respiration harmonics and intermodulation interference, this paper proposes a cancellation-before-estimation strategy. Firstly, we present the adaptive extensive cancellation algorithm (ECA) to suppress respiratory and its low-order harmonics. Then, we propose an adaptive harmonic enhanced trace (AHET) method to avoid intermodulation interference by refining the HR search region. Various experimental results validate the effectiveness of the proposed methods, demonstrating improvements in accuracy, robustness, and computational efficiency compared to conventional approaches based on the FMCW (Frequency Modulated Continuous Wave) system
Camera-based vital signs monitoring in recent years has attracted more and more researchers and the results are promising. However, a few research works focus on heart rate extraction under extremely low illumination environments. In this paper, we propose a novel framework for remote heart rate estimation under low-light conditions. This method uses singular spectrum analysis (SSA) to decompose the filtered signal into several reconstructed components. A spectral masking algorithm is utilized to refine the preliminary candidate components on the basis of a reference heart rate. The contributive components are fused into the final pulse signal. To evaluate the performance of our framework in low-light conditions, the proposed approach is tested on a large-scale multi-illumination HR dataset (named MIHR). The test results verify that the proposed method has stronger robustness to low illumination than state-of-the-art methods, effectively improving the signal-to-noise ratio and heart rate estimation precision. We further perform experiments on the PUlse RatE detection (PURE) dataset which is recorded under normal light conditions to demonstrate the generalization of our method. The experiment results show that our method can stably detect pulse rate and achieve comparative results. The proposed method pioneers a new solution to the remote heart rate estimation in low-light conditions.
Large language models (LLMs) are revolutionizing healthcare by improving diagnosis, patient care, and decision support through interactive communication. More recently, they have been applied to analyzing physiological time-series like wearable data for health insight extraction. Existing methods embed raw numerical sequences directly into prompts, which exceeds token limits and increases computational costs. Additionally, some studies integrated features extracted from time-series in textual prompts or applied multimodal approaches. However, these methods often produce generic and unreliable outputs due to LLMs' limited analytical rigor and inefficiency in interpreting continuous waveforms. In this paper, we develop an LLM-powered agent for physiological time-series analysis aimed to bridge the gap in integrating LLMs with well-established analytical tools. Built on the OpenCHA, an open-source LLM-powered framework, our agent powered by OpenAI's GPT-3.5-turbo model features an orchestrator that integrates user interaction, data sources, and analytical tools to generate accurate health insights. To evaluate its effectiveness, we implement a case study on heart rate (HR) estimation from Photoplethysmogram (PPG) signals using a dataset of PPG and Electrocardiogram (ECG) recordings in a remote health monitoring study. The agent's performance is benchmarked against OpenAI GPT-4o-mini and GPT-4o, with ECG serving as the gold standard for HR estimation. Results demonstrate that our agent significantly outperforms benchmark models by achieving lower error rates and more reliable HR estimations. The agent implementation is publicly available on GitHub.
Heart rate (HR) estimation via remote photoplethysmography (rPPG) offers a non-invasive solution for health monitoring. However, traditional single-modality approaches (RGB or Radio Frequency (RF)) face challenges in balancing robustness and accuracy due to lighting variations, motion artifacts, and skin tone bias. In this paper, we propose CardiacMamba, a multimodal RGB-RF fusion framework that leverages the complementary strengths of both modalities. It introduces the Temporal Difference Mamba Module (TDMM) to capture dynamic changes in RF signals using timing differences between frames, enhancing the extraction of local and global features. Additionally, CardiacMamba employs a Bidirectional SSM for cross-modal alignment and a Channel-wise Fast Fourier Transform (CFFT) to effectively capture and refine the frequency domain characteristics of RGB and RF signals, ultimately improving heart rate estimation accuracy and periodicity detection. Extensive experiments on the EquiPleth dataset demonstrate state-of-the-art performance, achieving marked improvements in accuracy and robustness. CardiacMamba significantly mitigates skin tone bias, reducing performance disparities across demographic groups, and maintains resilience under missing-modality scenarios. By addressing critical challenges in fairness, adaptability, and precision, the framework advances rPPG technology toward reliable real-world deployment in healthcare. The codes are available at: https://github.com/WuZheng42/CardiacMamba.
Remote photoplethysmography (rPPG) aims to measure non-contact physiological signals from facial videos, which has shown great potential in many applications. Most existing methods directly extract video-based rPPG features by designing neural networks for heart rate estimation. Although they can achieve acceptable results, the recovery of rPPG signal faces intractable challenges when interference from real-world scenarios takes place on facial video. Specifically, facial videos are inevitably affected by non-physiological factors (e.g., camera device noise, defocus, and motion blur), leading to the distortion of extracted rPPG signals. Recent rPPG extraction methods are easily affected by interference and degradation, resulting in noisy rPPG signals. In this paper, we propose a novel method named CodePhys, which innovatively treats rPPG measurement as a code query task in a noise-free proxy space (i.e., codebook) constructed by ground-truth PPG signals. We consider noisy rPPG features as queries and generate high-fidelity rPPG features by matching them with noise-free PPG features from the codebook. Our approach also incorporates a spatial-aware encoder network with a spatial attention mechanism to highlight physiologically active areas and uses a distillation loss to reduce the influence of non-periodic visual interference. Experimental results on four benchmark datasets demonstrate that CodePhys outperforms state-of-the-art methods in both intra-dataset and cross-dataset settings.
Heart rate (HR) estimation from photoplethysmography (PPG) signals is a key feature of modern wearable devices for health and wellness monitoring. While deep learning models show promise, their performance relies on the availability of large datasets. We present EnhancePPG, a method that enhances state-of-the-art models by integrating self-supervised learning with data augmentation (DA). Our approach combines self-supervised pre-training with DA, allowing the model to learn more generalizable features, without needing more labelled data. Inspired by a U-Net-like autoencoder architecture, we utilize unsupervised PPG signal reconstruction, taking advantage of large amounts of unlabeled data during the pre-training phase combined with data augmentation, to improve state-of-the-art models' performance. Thanks to our approach and minimal modification to the state-of-the-art model, we improve the best HR estimation by 12.2%, lowering from 4.03 Beats-Per-Minute (BPM) to 3.54 BPM the error on PPG-DaLiA. Importantly, our EnhancePPG approach focuses exclusively on the training of the selected deep learning model, without significantly increasing its inference latency
Reflective photoplethysmography (PPG) has become the default sensing technique in wearable devices to monitor cardiac activity via a person's heart rate (HR). However, PPG-based HR estimates can be substantially impacted by factors such as the wearer's activities, sensor placement and resulting motion artifacts, as well as environmental characteristics such as temperature and ambient light. These and other factors can significantly impact and decrease HR prediction reliability. In this paper, we show that state-of-the-art HR estimation methods struggle when processing \emph{representative} data from everyday activities in outdoor environments, likely because they rely on existing datasets that captured controlled conditions. We introduce a novel multimodal dataset and benchmark results for continuous PPG recordings during outdoor activities from 16 participants over 13.5 hours, captured from four wearable sensors, each worn at a different location on the body, totaling 216\,hours. Our recordings include accelerometer, temperature, and altitude data, as well as a synchronized Lead I-based electrocardiogram for ground-truth HR references. Participants completed a round trip from Zurich to Jungfraujoch, a tall mountain in Switzerland over the course of one day. The trip included outdoor and indoor activities such as walking, hiking, stair climbing, eating, drinking, and resting at various temperatures and altitudes (up to 3,571\,m above sea level) as well as using cars, trains, cable cars, and lifts for transport -- all of which impacted participants' physiological dynamics. We also present a novel method that estimates HR values more robustly in such real-world scenarios than existing baselines.
We present our work on leveraging low-frame-rate monochrome (blue light) videos of fingertips, captured with an off-the-shelf fingerprint capture device, to extract vital signs and identify users. These videos utilize photoplethysmography (PPG), commonly used to measure vital signs like heart rate. While prior research predominantly utilizes high-frame-rate, multi-wavelength PPG sensors (e.g., infrared, red, or RGB), our preliminary findings demonstrate that both user identification and vital sign extraction are achievable with the low-frame-rate data we collected. Preliminary results are promising, with low error rates for both heart rate estimation and user authentication. These results indicate promise for effective biometric systems. We anticipate further optimization will enhance accuracy and advance healthcare and security.
Today's fitness bands and smartwatches typically track heart rates (HR) using optical sensors. Large behavioral studies such as the UK Biobank use activity trackers without such optical sensors and thus lack HR data, which could reveal valuable health trends for the wider population. In this paper, we present the first dataset of wrist-worn accelerometer recordings and electrocardiogram references in uncontrolled at-home settings to investigate the recent promise of IMU-only HR estimation via ballistocardiograms. Our recordings are from 42 patients during the night, totaling 310 hours. We also introduce a frequency-based method to extract HR via curve tracing from IMU recordings while rejecting motion artifacts. Using our dataset, we analyze existing baselines and show that our method achieves a mean absolute error of 0.88 bpm -- 76% better than previous approaches. Our results validate the potential of IMU-only HR estimation as a key indicator of cardiac activity in existing longitudinal studies to discover novel health insights. Our dataset, Nightbeat-DB, and our source code are available on GitHub: https://github.com/eth-siplab/Nightbeat.
Doppler ultrasound is widely used to monitor fetal heart rate during labor and pregnancy. Unfortunately, it is highly sensitive to fetal and maternal movements, which can cause the displacement of the fetal heart with respect to the ultrasound beam, in turn reducing the Doppler signal-to-noise ratio and leading to erratic, noisy, or missing heart rate readings. To tackle this issue, we augment the conventional Doppler ultrasound system with a rational agent that autonomously steers the ultrasound beam to track the position of the fetal heart. The proposed cognitive ultrasound system leverages a sequential Monte Carlo method to infer the fetal heart position from the power Doppler signal, and employs a greedy information-seeking criterion to select the steering angle that minimizes the positional uncertainty for future timesteps. The fetal heart rate is then calculated using the Doppler signal at the estimated fetal heart position. Our results show that the system can accurately track the fetal heart position across challenging signal-to-noise ratio scenarios, mainly thanks to its dynamic transmit beam steering capability. Additionally, we find that optimizing the transmit beamsteering to minimize positional uncertainty also optimizes downstream heart rate estimation performance. In conclusion, this work showcases the power of closed-loop cognitive ultrasound in boosting the capabilities of traditional systems.
In recent years, deep learning methods have shown impressive results for camera-based remote physiological signal estimation, clearly surpassing traditional methods. However, the performance and generalization ability of Deep Neural Networks heavily depends on rich training data truly representing different factors of variation encountered in real applications. Unfortunately, many current remote photoplethysmography (rPPG) datasets lack diversity, particularly in darker skin tones, leading to biased performance of existing rPPG approaches. To mitigate this bias, we introduce PhysFlow, a novel method for augmenting skin diversity in remote heart rate estimation using conditional normalizing flows. PhysFlow adopts end-to-end training optimization, enabling simultaneous training of supervised rPPG approaches on both original and generated data. Additionally, we condition our model using CIELAB color space skin features directly extracted from the facial videos without the need for skin-tone labels. We validate PhysFlow on publicly available datasets, UCLA-rPPG and MMPD, demonstrating reduced heart rate error, particularly in dark skin tones. Furthermore, we demonstrate its versatility and adaptability across different data-driven rPPG methods.
Acoustic signals are crucial for health monitoring, particularly heart sounds which provide essential data like heart rate and detect cardiac anomalies such as murmurs. This study utilizes a publicly available phonocardiogram (PCG) dataset to estimate heart rate using model-driven methods and extends the best-performing model to a multi-task learning (MTL) framework for simultaneous heart rate estimation and murmur detection. Heart rate estimates are derived using a sliding window technique on heart sound snippets, analyzed with a combination of acoustic features (Mel spectrogram, cepstral coefficients, power spectral density, root mean square energy). Our findings indicate that a 2D convolutional neural network (\textbf{\texttt{2dCNN}}) is most effective for heart rate estimation, achieving a mean absolute error (MAE) of 1.312 bpm. We systematically investigate the impact of different feature combinations and find that utilizing all four features yields the best results. The MTL model (\textbf{\texttt{2dCNN-MTL}}) achieves accuracy over 95% in murmur detection, surpassing existing models, while maintaining an MAE of 1.636 bpm in heart rate estimation, satisfying the requirements stated by Association for the Advancement of Medical Instrumentation (AAMI).
Accurate extraction of heart rate from photoplethysmography (PPG) signals remains challenging due to motion artifacts and signal degradation. Although deep learning methods trained as a data-driven inference problem offer promising solutions, they often underutilize existing knowledge from the medical and signal processing community. In this paper, we address three shortcomings of deep learning models: motion artifact removal, degradation assessment, and physiologically plausible analysis of the PPG signal. We propose KID-PPG, a knowledge-informed deep learning model that integrates expert knowledge through adaptive linear filtering, deep probabilistic inference, and data augmentation. We evaluate KID-PPG on the PPGDalia dataset, achieving an average mean absolute error of 2.85 beats per minute, surpassing existing reproducible methods. Our results demonstrate a significant performance improvement in heart rate tracking through the incorporation of prior knowledge into deep learning models. This approach shows promise in enhancing various biomedical applications by incorporating existing expert knowledge in deep learning models.