Heart Rate Variability (HRV)生理訊號分析已被廣泛運用在醫學臨床診斷上，然而在心電圖圖形中，HRV分析無法取得所有的生理資訊。有鑑於此，本文提供一種新的R-Wave Amplitude Variability (RAV)生理訊號參數分析法，可從ECG中取得不同於HRV分析所法取得之生理訊號。RAV生理訊號參數分析法是取出ECG中每個心跳的R波振幅，再進行傅立葉轉換到頻域空間，分析其功率頻譜，從不同的頻率範圍之功率當中，定義出能代表生理訊號的參數，並進行統計。另外同時使用線性迴歸分析的方法，分析HRV及RAV生理訊號之間的線性相關度，以比較兩種分析方法的異同。在20位實驗樣本四種不同姿勢中，我們得到右側臥之RAV參數在統計上和左側臥、仰臥、坐姿等三種姿勢有差異；迴歸分析的結果則顯示，兩種分析方法所得的結果有部分線性相關度佳，而有部分關聯性差。因此我們認為這種新的分析方法有別於HRV分析方法，且確實可用於臨床研究。

Analysis of HRV is generally used in clinical diagnosis. But HRV method could not get full physiological information from ECG. Therefore, This thesis suggested a new method - R-wave amplitude variability (RAV), which could find physiological information from ECG that differs form HRV. The way to analyze RAV physiological parameter is to get R-wave amplitude from each heart beat in ECG, useing Foureir transfrom transferd to frequency domain and analyzed its power spectrum. Then we defined physiological parameter which could represented physiological status from power spectrum by different frequency range, and proceed statistical analysis. Besides, we use linear regression method to check the linear correlation between HRV and RAV to confirm the two analytic method is different. In 20 samples at four differnet posture, we find human at right decubitus is much different form the other posture; and some parameter of RAV and HRV have better linear correlation and the other are worse. We concluded that the RAV method differs from HRV method and could be used in clinical diagnosis.

[1] Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, “Heart Rate Variability: Standard of Measurement, Physiological Interpretation, and Clinical Use”, Circulation 1996, 93, 1043-1065
[2] 蔡榮基, 臨床心臟內科學, 1984
[3] 廖述朗, 臨床心電圖學, 1987
[4] Hale S, Statistical Essays, Vol. II, 1933
[5] Hon EH, Lee ST, “Electronic Evaluation of the Fetal Heart Rate Patterns Proceeding Fetal Death: Further Observations”, Am J Obstet Gynecol, 1965, 87, 814-826
[6] Askelrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ, “Power Spectrum Analysis of Heart Rate Fluctuation: a Quantitative Probe of Beat to Beat Cardiovascular Control”, Science, 1981, 213, 220-222
[7] Kitney RI, Rompelman O, The Study of Heart Rate Variability, 1980
[8] Parer WJ, Parer JT, Holbrook RH, Block BS, “Validity of Mathematical Method of Quantitating Fetal Heart Rate Variability”, Am J Obstet Gynecol, 1985, 153, 402-409
[9] Kay SM, Marple SL, “Spectrum Analysis: A Modern Perspective”, Proc IEEE, 1981, 69, 939
[10] Falkner B, Lowenthal DT, Affrime MB, Hamstra B, “R-Wave Amplitude Change During Aerobic Exercise in Hypertensive Adolescents After Treatment”, American Journal of Cardiology, 1983, 51(3), 459-63
[11] Ikeda K, Kubota I, Yamaki M, Igarashi H, Nakamura K, Tuiki K, Yasui S, “Local Conduction Delay Causes R-Wave Amplitude Increase in Patients with Effort Angina”, Journal of Electrocardiology, 1988, 21(1), 39-44
[12] Grosse-Heitmeyer W, “Is There a Specific Response of the ECG R-Wave Amplitude to Exercise-Induced Myocardial Ischemia? Exercise Test and Dipyridamole Test”, Schweizerische Medizinische Wochenschrift. Journal Suisse de Medecine, 1993, 123(10), 414-21
[13] Lipsitz LA, Mietus J, Moody GB, Goldberger AL, “Spectral Characteristics of Heart Rate Variability Before and During Postural Tilt: Relations to Aging and Risk of Syncope”, Circulation, 1990, 81, 1803-1810
[14] P. D. Welch, “A Fixed-Point Fast Fourier Transform Analysis”, IEEE Trans. Audio Electroacoust. , 1969, Vol.17, No. 2, 151-157
[15] Mark Cartwright, Fourier Methods, 1990
[16] Ellen R. Girden, ANOVA Repeated Measures, 1992
[17] Richard J. Shavelson, Statistical Reasoning for the Behavioral Sciences, 1996
[18] George Diekhoff, Statistics for the Social and Behavioral Sciences, 1992
[19] James D. Evans, Straightforward Statistics for the Behavioral Sciences, 1996
[20] Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dellorto S, Piccaluga E, Turiel M, Baselli G, Cerutti S, Malliani A, “Power Spetral Analysis of Heart Rate and Arterial Pressure Variabilities as a Marker of Sympathovagal Interaction in Man and Conscious Dog”, Circ Res, 1986, 59, 178-193
[21] Vybirl T, Bryg RJ, Maddens ME, Boden WE, “Effect of Passive Tilt on Sympathetic and Parasympathetic Components of Heart Rate Variability in Normal Subjects”, Am J Cardiol, 1989, 63, 1117-1120
[22] 陳高揚, “以心率變異度分析研究佛教對臥姿的規範-獅子王臥-”, 國立陽明大學傳統醫藥學研究所碩士論文, 1995