ZOE Science & Nutrition

HRV vs. VO2 max vs. ECG: Which wearable metric ACTUALLY matters? | Prof. Malcolm Findlay

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Oct 2, 2025
Guest
Prof. Malcolm Findlay
In this engaging discussion, Prof. Malcolm Findlay, a board-certified cardiologist and electrophysiologist, shares his expertise on heart metrics and wearables. He explains why heart rate variability (HRV) is a key indicator of health and how more variability often signals better heart function. Findlay also highlights the reliability of smartwatch ECGs for diagnosing issues like atrial fibrillation. He demystifies factors affecting HRV, such as stress and sleep, and encourages listeners to utilize wearables for personal health management.
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INSIGHT

What HRV Actually Measures

  • HRV measures subtle beat-to-beat timing ‘wobbles’ rather than large rate changes from activity.
  • It gives insight into nervous-system balance but is weaker than some clinical tests for predicting disease.
INSIGHT

Why More Variability Is Better

  • Higher HRV usually signals stronger dual nervous inputs (sympathetic and parasympathetic) to the heart.
  • Very low HRV (near zero) occurs when nerve input is lost, e.g., after a heart transplant.
INSIGHT

When HRV Doesn’t Apply

  • HRV is invalid when a person has atrial fibrillation because chaotic electrical activity overwhelms normal control.
  • In AF the beat-to-beat irregularity reflects disease, not healthy autonomic balance.
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