Introducing BisQ, A Bicoherence-Based Nonlinear Index to Explore the Heart Rhythm

Nonlinear frequency coupling is assessed with bispectral measures, such as bicoherence. In this study, BisQ, a new bicoherence-derived index, is proposed for assessing nonlinear processes in cardiac regulation. To find BisQ, 110 ten-minute ECG traces obtained from 55 participants were initially studied. Via bispectral analysis, a bicoherence matrix (BC) was obtained from each trace (0.06 to 1.8 Hz with a resolution of 0.01 Hz). Each frequency pair in BC was tested for correlation with the HRV recurrent quantification analysis (RQA) index Lmean, obtained from tachograms from the same ECG trace. BisQ is the result of adding BC values corresponding to the three frequency pairs exhibiting the highest correlation with Lmean. BisQ values were estimated for different groups of subjects: Healthy persons, persons with arrhythmia, persons with epilepsy, and preterm neonates. ECG traces from persons with arrhythmia showed no significant differences in BisQ values respect to healthy persons, while persons with epilepsy and neonates showed higher BisQ values (p < 0.05; Mann-Whitney U-test). BisQ reflects nonlinear interactions at the level of sinus-and atrial-ventricular nodes, and most likely cardiorespiratory coupling as well. We expect that BisQ will allow for further exploration of cardiac nonlinear dynamics, complementing available HRV indices.